Craig, Denise, Ray, Robin, Harvey, Desley, and Shircore, Mandy (2020) Factors which influence hospital doctors' Advance Care Plan adherence. Journal of Pain and Symptom Management, 59 (5). pp. 1109-1126.

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Abstract

Context. Advances in medicine have seen changes in mortality in Western countries. Simultaneously, countries such as Australia, Canada, U.S., New Zealand, U.K., and Germany have encouraged consumer-directed care and advance care plan(ACP) completion, giving patients a voice despite incapacity. Adhering to ACPs relies on the decision-making of treating doctors, making hospital doctors key partners, and their perspectives on ACP adherence critical.

Objectives. The aim of this review was to explore and map existing research on factors associated with hospital doctorsadhering to adult patients' ACPs.

Methods. A scoping review of English language publications within CINAHL, Emcare, Medline, PsycInfo, and Scopus wasconducted, following PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. ACPs were defined as adult patient-generated, written health care directions or values statements. Studies of any design, which reported original researchassociated with hospital doctors adhering to ACPs, were included.

Results. Twenty-seven publications were included in the final analysis. Results suggested ACPs were thought potentially useful; however, adherence has been associated with doctors' attributes (e.g., specialty, seniority), attitudes toward ACP (e.g.,applicability), and legal knowledge.

Conclusion. Current literature suggests doctors hold largely positive attitudes toward ACPs that provide useful patientinformation that enables doctors to make appropriate treatment decisions. Doctors often perceive limitations to ACP applicability due to legal requirements or ambiguity of patient outcome goals.

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