Shared care planning in primary home palliative care: a single-center, retrospective observational study

This retrospective single-center study describes the use and content of Advance Care Planning (ACP) forms in a sample of 50 anonymized medical records of patients enrolled in a home-based primary palliative care program. ACP was documented in 62% of cases, with frequent reporting of hospitalization preferences (90.3%) and appointment of a healthcare proxy (90.3%), whereas treatment decisions and palliative sedation were less frequently addressed (45.2% and 16.1%, respectively). ACP discussions always involved the patient and the general practitioner (100%), with frequent participation of family members (87%) and palliative care nurses (61%), and only marginal involvement of other healthcare professionals (16%). These findings suggest that ACP is already integrated into clinical practice in this home-based primary palliative care setting; however, additional support may be needed to address more complex shared clinical decisions. Further, larger multicentric studies are needed to better understand the barriers and facilitators to ACP implementation in clinical practice.