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Katia Assimakis1, Alice Serafini2, Anna Tusini1

  • 1Dipartimento di Cure primarie, Azienda unità sanitaria locale di Modena.

Recenti Progressi in Medicina
|April 13, 2026
PubMed
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Advance Care Planning (ACP) documentation is present in 62% of home-based palliative care patients. While preferences and proxies are often recorded, complex decisions and broader team involvement require further support.

Area of Science:

  • Palliative Care
  • Medical Ethics
  • Health Services Research

Background:

  • Advance Care Planning (ACP) is crucial for aligning patient preferences with medical care, especially in palliative settings.
  • Home-based primary palliative care programs offer a unique context for implementing ACP.
  • Understanding current ACP practices is essential for improving patient-centered care.

Purpose of the Study:

  • To describe the utilization and content of Advance Care Planning (ACP) forms.
  • To analyze the documentation of specific ACP elements and participant involvement.
  • To identify areas for improvement in ACP within home-based palliative care.

Main Methods:

  • Retrospective analysis of 50 anonymized medical records from a single-center home-based primary palliative care program.

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  • Review of Advance Care Planning (ACP) documentation, including preferences, proxy appointment, treatment decisions, and palliative sedation.
  • Assessment of participant involvement in ACP discussions (patient, GP, family, nurses, other professionals).

    • Main Results:

    • Advance Care Planning (ACP) was documented in 62% of cases.
    • Hospitalization preferences (90.3%) and healthcare proxy appointment (90.3%) were frequently documented.
    • Treatment decisions (45.2%) and palliative sedation (16.1%) were less commonly addressed.
    • Discussions consistently included patients and general practitioners (100%), with frequent family (87%) and palliative nurse (61%) involvement.
    • Other healthcare professionals had marginal involvement (16%).

    Conclusions:

    • Advance Care Planning (ACP) is integrated into home-based palliative care, particularly for preferences and proxies.
    • Gaps exist in documenting complex treatment decisions and palliative sedation.
    • Enhanced support is needed for shared decision-making and broader interprofessional collaboration in ACP.