Assessing Advance Care Planning in Individuals with Lynch Syndrome

Authors: Fenton VN, Burton-Chase AM, Fletcher L, Bowles J, Hennig K.

Category: Behavioral Science & Health Communication
Conference Year: 2021

Abstract Body:
Purpose: The goal of this study is to assess knowledge and utilization of Advance Care Planning (ACP) in individuals with Lynch Syndrome (LS), evaluate preferences regarding these documents, and identify barriers to ACP conversations and document completion. Methods: A mixed methods approach (quantitative survey, follow-up telephone interview) was used to assess knowledge, preferences, and attitudes regarding ACP (n=20). This study also assessed which ACP documents individuals already had in place and which persons an individual made aware of the documentation and/or preferences. Data were analyzed to determine preferences for who is responsible for initiating these conversations, identify motivating factors and barriers to these conversations, and determine whether the current conversations are adequate to meet the needs of this population. Results: Participants recognized the importance of ACP and expressed interest in creating these documents. However, knowledge and confidence about these topics were lacking, with many participants attributing this to their young age and lack of experience. There also was a disparity in how participants received information versus how they wished to receive information. Most participants were informed about ACP by their experiences, while they wished to have more guidance and one-on-one instruction from their providers. Younger participants reported not being asked about advance directives. Participants reported that a key factor in conversations about ACP is comfort with the healthcare provider (HCP). The provider specialty was not an important factor in whether participants wanted to have this conversation with a HCP, rather it was their level of trust in the provider and the nature of the patient-provider relationship. Conclusions: Although uncomfortable, many patients want to have ACP discussions with their providers, but frequently patients were only asked if these documents are completed with no further discussion. We ultimately believe ACP should be included as the standard of care for all individuals, not just those with LS, to help reduce the barriers for completion. These findings can inform educational efforts to improve knowledge of ACP and interventional research to increase use of ACP by individuals with

Keywords: Lynch Syndrome, Advance Care Planning, Patient Communication