Evidence map›Paper›PMID 35790910›Full record

ArticleBMC geriatrics2022

The patient's relationship with the General Practitioner before and after Advance Care Planning: pre/post-implementation study.

Annicka G M van der Plas, Julia E A P Schellekens, Jolien J Glaudemans, Bregje D Onwuteaka-Philipsen

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Article in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Annicka G M van der PlasDepartment of Public and Occupational Health, Amsterdam UMC, Location VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. eol@amsterdamumc.nl.
Julia E A P SchellekensDepartment of Public and Occupational Health, Amsterdam UMC, Location VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Jolien J GlaudemansAmsterdam UMC, Location AMC, Section of Medical Ethics, Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Bregje D Onwuteaka-PhilipsenDepartment of Public and Occupational Health, Amsterdam UMC, Location VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGeneral Practitioners (GPs) are central in the care of Dutch older people and in a good position to have Advance Care Planning (ACP) conversations. Interview studies reveal that the doctor-patient relationship is important when initiating ACP conversations and can also be influenced by ACP conversations. We aimed to examine the association between having an ACP conversation and the patient feeling the GP knows him or her and the patient trusting the GP and vice versa.

methodsImplementation of ACP in primary care was evaluated in a pre-and post design. Questionnaires before implementation of ACP and 14 months later were sent to patients aged 75 years or older within 10 GP-practices and 2 care homes. Multivariable logistic regression was used to model the relationship between ACP conversations during implementation and the patient-GP relationship before implementation. Odds ratios were adjusted for potential confounders. Generalized ordered logistic regression was used to model the relationship between the changes in patient-GP relationship before and after implementation and ACP conversations during implementation.

resultsFour hundred fifty-eight patients filled out the pre- and post-test questionnaire. There was no association between the GP knowing the patient and trust in the pre-test and having an ACP conversation during the implementation. For people who had had an ACP conversation at the end of the implementation period their trust remained more often the same or was higher after implementation (trust to provide good care OR 2.93; trust to follow their wishes OR 2.59), compared to patients who did not have an ACP conversation. A reduction in trust was less likely to happen to patients who had an ACP conversation compared to patients who did not have an ACP conversation.

conclusionsAlthough we have not found evidence for trust as a prerequisite for ACP conversations, this paper shows that ACP conversations can be beneficial for the doctor-patient relationship.

Indexed as

Advance Care PlanningGeneral PractitionersAgedCommunicationFemaleHumansMalePhysician-Patient RelationsTrustAdvance care planningAdvance directivesCommunicationGeneral practiceHealth services for the agedPhysician–patient relations

Identifiers

PMID35790910
PMCPMC9254656

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Registered trials

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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.