Barriers to advance care planning in primary care

One of the main themes to emerge from Mitchell and colleagues’ qualitative data analysis is the importance of advance care planning (ACP) in identifying early palliative care needs and recognising the end of life.¹ Other benefits of ACP include less aggressive medical care, improved quality of life near death, assisting families to prepare for a loved one’s death, resolving family conflict, and coping with bereavement.² Patients however may not wish to engage in discussions about future care as it involves them thinking about a deterioration in their condition and some GPs may be unwilling to initiate ACP discussions as they feel discussing prognosis with patients will cause undue distress and destroy hope.³

ACP has the potential to promote patient autonomy and shared decision making,⁴ but without a significant change in patients’ perception and GP attitudes it is unlikely to be more widely adopted.

• © British Journal of General Practice 2016