The COVID-19 pandemic prompted the public to become more aware of and interested in advance care planning, with a growing number of patients exerting efforts to have their wishes properly documented so that they would be respected, finds a new study (Funk et al. 2020).
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Study authors note that, amidst pandemic-related concerns, there is "a new openness" of patients to engage in advance care planning, an often neglected aspect of healthcare.
This retrospective and observational study, conducted in the first six months of 2020, examined the impact that COVID-19 had on advance care planning in the state of West Virginia. Data were sourced from the West Virginia Center for End-of-Life Care, including nature of calls to the centre, volume and types of documents requested from and submitted to the centre and its e-Directive Registry. These data were compared with those from the same months in the preceding six years.
Based on the results, the authors observed that during the first half of 2020 the nature of calls changed to COVID-19-related topics, including urgent desire to initiate advance care planning, temporary rescindment of treatment-limiting forms, and confirmation of forms submitted to the registry. In addition, callers were keen to find out how patients' wishes in advance directives and medical orders will be honoured in light of their COVID-19 status.
Meanwhile, the centre distributed more advance directives during the first six months of the year (when pandemic shutdown occurred), as compared to volumes in the same months during the last five years. There was also a significant increase in medical order distribution compared to what the centre had in the preceding four years.
"Healthcare providers requested an additional 1,600 more POST [physician orders for scope of treatment] forms and 450 more DNR [do-not-resuscitate] cards than were actually distributed during the study period because of pandemic-related distribution limits per request," the authors explained.
The COVID-19 pandemic has resulted in dramatic changes in healthcare, according to the authors, and the changes observed in West Virginia may provide a glimpse into what may be a greater receptivity to advance care planning in the whole country in the future.