Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care
Open accessAbstract
Advance care planning (ACP) is increasingly implemented in oncology and beyond, but a definition of ACP and recommendations concerning its use are lacking. We used a formal Delphi consensus process to help develop a definition of ACP and provide recommendations for its application. Of the 109 experts (82 from Europe, 16 from North America, and 11 from Australia) who rated the ACP definitions and its 41 recommendations, agreement for each definition or recommendation was between 68-100%. ACP was defined as the ability to enable individuals to define goals and preferences for future medical treatment and care, to discuss these goals and preferences with family and health-care providers, and to record and review these preferences if appropriate. Recommendations included the adaptation of ACP based on the readiness of the individual; targeting ACP content as the individual's health condition worsens; and, using trained non-physician facilitators to support the ACP process. We present a list of outcome measures to enable the pooling and comparison of results of ACP studies. We believe that our recommendations can provide guidance for clinical practice, ACP policy, and research.
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- Authors
- Rietjens, J. A. C., Sudore, R. L., Connolly, M., van Delden, J. J., Drickamer, M. A., Droger, M., van der Heide, A., Heyland, D. K., Houttekier, D., Janssen, D. J. A., Orsi, L., Payne, S., Seymour, J., Jox, R. J., & Korfage, I. J.
- Affiliations
- Erasmus MC (NL)
- San Francisco VA Medical Center (US)
- University College Dublin (IE)
- University of North Carolina at Chapel Hill (US)
- Queen's University (CA)
- Vrije Universiteit Brussel (BE)
- Maastricht University Medical Centre (NL)
- Azienda Ospedaliera Carlo Poma (IT)
- Lancaster University (GB)
- University of Sheffield (GB)
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Rietjens, Judith A C
- ORCID
- Venue
- The Lancet Oncology
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 18
- Issue
- 9
- Pages
- e543-e551
- ISSN
- 1470-2045 (ISSN-L)
- OpenAlex
- W2753659610
- Cited by
- 1,371
- References
- 77
- Citations by year
- 2026: 164 · 2025: 176 · 2024: 230 · 2023: 166 · 2022: 158 · 2021: 160 · 2020: 157 · 2019: 104 · 2018: 54 · 2017: 2
- FWCI
- 81.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet Oncology (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- Lancaster EPrints (Lancaster University) (acceptedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- eScholarship (California Digital Library) (submittedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- L'Oreal USA
- Japanese Association of Cardiac Rehabilitation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- advance care planning, clinical guidelines, patient preferences, goals of care, outcome measures, palliative care, end-of-life care
- MeSH terms
- Attitude of Health Personnel, Delphi Technique, Humans, Palliative Care, Advance Care Planning
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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