TY - JOUR
T1 - Advance care planning in patients with cancer referred to a phase I clinical trials program
T2 - The md anderson cancer center experience
AU - Fu, Siqing
AU - Barber, F. Diane
AU - Naing, Aung
AU - Wheler, Jennifer
AU - Hong, David
AU - Falchook, Gerald
AU - Piha-Paul, Sarina
AU - Tsimberidou, Apostolia
AU - Howard, Adrienne
AU - Kurzrock, Razelle
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012
Y1 - 2012
N2 - Purpose: Patients with advanced malignancies referred for early clinical trials have a short life expectancy. We designed this survey to ascertain the status of advance care planning in this population. Patients and Methods: Patients who were seen in a phase I clinic were asked to anonymously complete an investigator-designed survey. Results: Of 435 individuals approached, 215 (49%) returned completed or partially completed surveys, whereas many others stated that they wanted to avoid the topic, because they had come to the phase I clinic for cancer therapy. Most patients (n = 149; 69%) were still hopeful about their future. Approximately 42% of patients (n = 90) reported having a living will, 46% had a medical power of attorney (n = 98), and 19% had a do-not-resuscitate (DNR) order (n = 40). Approximately 20% of participants (n = 43) had not discussed advance care planning. Fifty-nine percent of patients wanted to discuss advance care planning with their physician. Having a DNR order in place was significantly more common in individuals who had a living will and/or a medical power of attorney. Conclusion: Although most patients referred to a phase I clinic remained optimistic, many had discussed a living will, medical power of attorney, and/or DNR order with their physician, family, and/or attorney. However, a significant minority had not addressed this issue with anyone, and many refused to take a survey on the topic. More than half of the patients wanted to discuss these matters with their physician. These observations suggest that extra effort to address advance care planning is needed for these patients.
AB - Purpose: Patients with advanced malignancies referred for early clinical trials have a short life expectancy. We designed this survey to ascertain the status of advance care planning in this population. Patients and Methods: Patients who were seen in a phase I clinic were asked to anonymously complete an investigator-designed survey. Results: Of 435 individuals approached, 215 (49%) returned completed or partially completed surveys, whereas many others stated that they wanted to avoid the topic, because they had come to the phase I clinic for cancer therapy. Most patients (n = 149; 69%) were still hopeful about their future. Approximately 42% of patients (n = 90) reported having a living will, 46% had a medical power of attorney (n = 98), and 19% had a do-not-resuscitate (DNR) order (n = 40). Approximately 20% of participants (n = 43) had not discussed advance care planning. Fifty-nine percent of patients wanted to discuss advance care planning with their physician. Having a DNR order in place was significantly more common in individuals who had a living will and/or a medical power of attorney. Conclusion: Although most patients referred to a phase I clinic remained optimistic, many had discussed a living will, medical power of attorney, and/or DNR order with their physician, family, and/or attorney. However, a significant minority had not addressed this issue with anyone, and many refused to take a survey on the topic. More than half of the patients wanted to discuss these matters with their physician. These observations suggest that extra effort to address advance care planning is needed for these patients.
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U2 - 10.1200/JCO.2011.38.0758
DO - 10.1200/JCO.2011.38.0758
M3 - Article
C2 - 22778314
AN - SCOPUS:84865062413
SN - 0732-183X
VL - 30
SP - 2891
EP - 2896
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 23
ER -