ArticleJournal of pain and symptom management2018
Advance Care Planning Documentation Practices and Accessibility in the Electronic Health Record: Implications for Patient Safety.
Article in Journal of pain and symptom management, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evaluating outcomes of advance care planning interventions for adults living with advanced illness and people close to them: A systematic meta-review.Palliative medicine · 2025Pooled it
- Trial
- FAmily-CEntered (FACE) Advance Care Planning Among African-American and Non-African-American Adults Living With HIV in Washington, DC: A Randomized Controlled Trial to Increase Documentation and Health Equity.Journal of pain and symptom management · 2019Trial
- Engaging Diverse English- and Spanish-Speaking Older Adults in Advance Care Planning: The PREPARE Randomized Clinical Trial.JAMA internal medicine · 2018Trial
- Improving a Full Range of Advance Care Planning Behavior Change and Action Domains: The PREPARE Randomized Trial.Journal of pain and symptom management · 2018Trial
- Patient Perspectives on Repeat Intubation Following Mechanical Ventilation: A Pilot Retrospective Survey Study.Cureus · 2026Article
- Large Language Models for Summarizing Advance Care Planning Information From Goals of Care Notes in the EHR.Learning health systems · 2026Article
- Barriers and Strategies to Effective Serious Illness Communication for Patients with End-Stage Liver Disease in the Intensive Care Setting.Journal of intensive care medicine · 2026Review
- Utility of advance care planning billing codes: a cross-sectional analysis of U.S. hospitalists' documentation.BMC research notes · 2025Article
- Increasing Advance Care Planning Discussions and Documentation.Journal of the advanced practitioner in oncology · 2025Article
- Patient-Reported Goals of Care in the Preoperative Clinic: Barriers to and Facilitators of Patient Values Elicitation and Documentation.Journal of surgical oncology · 2025Article
- Feasibility of a new transmural care pathway for advance care planning for older persons: A qualitative study into community care registered nurses' perspectives.International journal of nursing studies advances · 2024Article
- Impact of the COVID-19 Public Health Crisis and a Structured COVID Unit on Physician Behaviors in Code Status Ordering.The American journal of hospice & palliative care · 2024Article
- What Clinicians and Researchers Should Know About the Evolving Field of Advance Care Planning: a Narrative Review.Journal of general internal medicine · 2024Review
- Perceptions and experiences of onco-haematology professionals in relation to advance care planning: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Doctor's Perceptions of the Systemic Influences on Advance Care Plan Application: A Thematic Analysis.Journal of multidisciplinary healthcare · 2024Article
- Forms or Free-Text? Measuring Advance Care Planning Activity Using Electronic Health Records.Journal of pain and symptom management · 2023Review
- Social and healthcare professionals' experiences of end-of-life care planning and documentation in palliative care.Nursing open · 2023Article
- Implementation of a Standardized Shared Decision-making Bundle to Improve Communication Practices in the Neurocritical Care Unit.Neurology. Clinical practice · 2023Article
- Low rates of structured advance care planning documentation in electronic health records: results of a single-center observational study.BMC palliative care · 2022Observational
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
contextDocumenting patients' advance care planning (ACP) wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about ACP documentation practices in the electronic health record.
objectivesThe objective of this study was to describe ACP documentation practices and the accessibility of documented discussions in the electronic health record.
methodsParticipants were primary care patients at the San Francisco Veterans Affairs Medical Center, were ≥60 years old, and had ≥2 chronic/serious health conditions. In this cross-sectional study, we assessed the prevalence of ACP documentation, including any legal forms/orders and discussions in the prior five years. We also determined accessibility of discussions (i.e., accessible centralized posting vs. inaccessible free text in progress notes).
resultsThe mean age of 414 participants was 71 years (SD ± 8), 9% were women, 43% were nonwhite, and 51% had documented ACP including 149 (36%) with forms/orders and 138 (33%) with discussions. Seventy-four participants (50%) with forms/orders lacked accompanying explanatory documentation. Most (55%) discussions were not easily accessible, including 70% of those documenting changes in treatment preferences from prior forms/orders.
conclusionHalf of chronically ill, older participants had documented ACP, including one-third with documented discussions. However, half of the patients with completed legal forms/orders had no accompanying documented explanatory discussions, and the majority of documented discussions were not easily accessible, even when wishes had changed. Ensuring that patients' preferences are documented and easily accessible is an important patient safety and quality improvement target to ensure patients' wishes are honored.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.