e24039 Background: Advance Care Planning (ACP) plays a crucial role in ensuring that patients facing serious illness, such as cancer, can make decisions about their end-of-life care in line with their values and preferences. While ACP is recognized as essential for improving patient outcomes and reducing unnecessary medical interventions, many cancer patients still face challenges in initiating or completing ACP discussions and documentation. This study seeks to explore cancer patients' awareness of ACP, identify the barriers and facilitators to its implementation, and assess the perceived benefits. Methods: The study surveyed adult cancer patients from oncology clinic at Southeast Health Medical Center (n=111). Participants were selected based on their active participation in cancer treatment or being in remission, regardless of cancer type. A structured survey was administered, assessing patients’ awareness of ACP, prior discussions with healthcare providers, barriers to and facilitators of ACP, and the perceived benefits of ACP. Results: Of 200 surveys, 111 responses were received (response rate 55%), the median age was 62.9 years, with 68% participants female, 32% male. 36% of females and 42% of males were familiar with ACP. 31% of patients age 51 and older were familiar with ACP prior to cancer diagnosis. Most participants reported at least one barrier to ACP. The most frequently reported barrier was “the uncertainty of disease progression”, followed by “lack of information” and “emotional discomfort”. “Family Opposition” and “cultural or religious beliefs” were ranked low on reported barriers. 60% believed that ACP should only be discussed when all curative options are exhausted. The most frequently reported facilitators of ACP were, “understanding benefits of advanced care planning”, “clear information from healthcare providers”, “support from family and friends”, and “access to counseling or support groups” in descending order. There was no statistical significance between reported barriers and facilitators of ACP p=.997, X 2 =2.52. Conclusions: Fewer than half of surveyed patients were familiar with ACP, and most reported at least one barrier to engagement. Perceptions that ACP is only appropriate after exhausting curative options, uncertainty about disease course, emotional discomfort, and limited provider communication were common obstacles. Participants had hesitation discussing end-of-life topics, likely related to limited ACP education and variable health literacy in this population which may have attenuated response. Although no statistically significant associations between barriers and facilitators were detected, low familiarity and pervasive barriers across groups highlight need for earlier, longitudinal ACP integration, provider education, and culturally sensitive, standardized workflows in community oncology to support value-concordant care.
Thotli et al. (Thu,) studied this question.