Exploring patients’ advance care planning needs during the annual 75+ health assessment: survey of Australian GPs’ views and current practice
Joel Rhee
A B * , Mariko Carey C D , Alison Zucca C D and David Lambkin D
A The Discipline of General Practice, School of Population Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia.
B General Practice Academic Unit, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
C School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
D Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
Australian Journal of Primary Health - https://doi.org/10.1071/PY22227
Submitted: 10 October 2022 Accepted: 7 July 2023 Published online: 10 August 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: The 75+ health assessment has been identified as a suitable trigger to introduce advance care planning (ACP) to general practice patients. Australian general practitioners (GPs) were surveyed to explore their perceptions, attitudes and practices in introducing ACP during 75+ health assessments.
Methods: A cross-sectional postal survey of Australian GPs covering their personal, professional and workplace characteristics, their current practice regarding ACP within a 75+ health assessment, and their attitude towards ACP. Multivariate logistic regression was used to analyse the factors associated with routinely discussing ACP as part of the 75+ health assessment.
Results: A total of 185 (19.2%) out of 964 eligible GPs returned a completed survey. Most GPs reported that patients interested in ACP were supported by the GPs or the practice nurse. Two factors, (1) attitude that ACP is an essential component of the 75+ health assessment, and (2) regional or rural location of the practice, had a statistically and clinically significant association with the GP’s self-reported discussion of ACP during 75+ health assessments.
Conclusions: GPs showed a high level of support and involvement in discussing ACP during 75+ health assessments. ACP support during 75+ health assessments was often provided directly by the GP or via the practice nurse. Given the international evidence that ACP training programs improve skills and knowledge, and foster positive attitudes towards ACP, there is an important need to continue funding ACP training programs for GPs and practice nurses.
Keywords: 75+ health assessment, advance care planning, annual health assessment, cross-sectional survey, general practice, general practitioners, older adults, primary care.
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