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- Title
Perspectives on Advance Care Planning for Patients with Hematologic Malignancy: An International Clinician Questionnaire.
- Authors
Spring, Jenna; McKinlay, Jerrad; Puxty, Kathryn; Metaxa, Victoria; Detsky, Michael; Mehta, Sangeeta; Thyagu, Santhosh; McGuigan, Kelly; Munshi, Laveena
- Abstract
Rationale: Critical illness is common in patients with hematologic malignancy (HM). Advance care planning (ACP) can allow these patients to express their care preferences before life-threatening illnesses. Objectives: To evaluate physicians' perspectives surrounding ACP in patients with HM. Methods: We administered a survey to intensivists and hematologic oncologists who care for patients with HM across Canada and the United Kingdom. Potential respondents were identified from institutions that have a hematologic-oncology program. The survey was disseminated electronically. Results: A total of 111 physicians completed the survey, with a response rate of 19% (39% across those who opened the e-mail); 52% of respondents were intensivists, and 48% of respondents were hematologic oncologists. Of the responses, 15.5% of physicians reported that ACP happens routinely at their institution, whereas 8.3% of physicians stated that code status is routinely discussed. ACP discussions were most commonly reported at the onset of critical illness (84.3% of respondents), during disease recurrence (52.9% of respondents), or during the transition to a strictly palliative approach (54.9% of respondents). Commonly cited barriers to ACP centered on physicians' concern about the reaction of the patient or family. Conclusions: This study emphasizes the need for earlier and more frequent ACP discussions in this high-risk population with a variety of barriers identified.
- Subjects
HEMATOLOGIC agents; LEUKEMIA; STEM cell transplantation; CATASTROPHIC illness; CANCER treatment
- Publication
Annals of the American Thoracic Society, 2021, Vol 18, Issue 9, p1533
- ISSN
2329-6933
- Publication type
journal article
- DOI
10.1513/AnnalsATS.202006-678OC