TY - JOUR

T1 - Timing of advance care planning in patients with advanced cancer

T2 - analysis of ACTION data

AU - Zhu, Tingting

AU - Rietjens, Judith AC

AU - van Delden, Johannes J M

AU - Deliens, Luc

AU - van der Heide, Agnes

AU - Johnsen, Anna Thit

AU - Ingravallo, Francesca

AU - Lunder, Urška

AU - Preston, Nancy J

AU - Seymour, Jane

AU - Korfage, Ida J.

PY - 2025/3/29

Y1 - 2025/3/29

N2 - Objective To explore the experiences of patients with advanced cancer regarding the timing of ACP. Methods This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0–3, and with a minimum life expectancy of 3 months were included in this analysis. Results The mean time between patients’ cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as “just right” by 217 (75.3%) of the patients. Patients who perceived the timing as too early were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as too late had shorter estimated survival times. Conclusion Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice. Practice Implications When initiating ACP conversations, several aspects should be considered, including patients’ gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.

AB - Objective To explore the experiences of patients with advanced cancer regarding the timing of ACP. Methods This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0–3, and with a minimum life expectancy of 3 months were included in this analysis. Results The mean time between patients’ cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as “just right” by 217 (75.3%) of the patients. Patients who perceived the timing as too early were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as too late had shorter estimated survival times. Conclusion Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice. Practice Implications When initiating ACP conversations, several aspects should be considered, including patients’ gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.

U2 - 10.1016/j.pec.2025.108761

DO - 10.1016/j.pec.2025.108761

M3 - Journal article

VL - 136

JO - Patient Education and Counseling

JF - Patient Education and Counseling

SN - 0738-3991

M1 - 108761

ER -