a) Improving the impact of advance care planning on the quality of life and care of frail older people

 

Research contact

Dr Sarah Hopkins, Dunhill / British Geriatrics Society PhD Student
Email: saah2@medschl.cam.ac.uk
ORCiD: 0000-0002-5089-6496
Twitter: @saahopkins

Project length

2018 – 2026

Summary

This research aims to improve outcomes for frail older people through optimising discussions about values and preferences for future care, termed advance care planning (ACP).

During the first stage of the project, a systematic review of ACP with hospitalised frail older patients found that:

1. The experiences of patients, carers and clinicians are rarely sought and thus poorly understood
2. The mechanisms through which ACP improves outcomes are poorly understood
3. Low rates of ACP in hospital are not understood and so practice cannot be modified

The second stage of the project aims to fill these crucial knowledge gaps. It will use experience-based co-design to collaborate with frail older individuals, their carers and clinicians to improve ACP. Through combining in-depth qualitative research with implementation principles, it will provide insight into the benefits (or not) of ACP to all involved in order to co-design innovative yet realistic solutions.

Funding

The Evelyn Trust and Addenbrooke’s Charitable Trust Cambridge Clinical Research Fellowship (2018-2021)

Joint British Geriatrics Society and Dunhill Medical Trust Doctoral Training Fellowship (2021-2026)

Outputs

1. Hopkins SA, Bentley A, Phillips V, Barclay S. Advance care plans and hospitalized frail older adults: a systematic review. BMJ Support Palliat Care. 2020 Jun;10(2):164-174. doi: 10.1136/bmjspcare-2019-002093. Epub 2020 Apr 2. PMID: 32241957; PMCID: PMC7286036.
2. Hopkins SA, Lovick R, Polak L, Bowers B, Morgan T, Kelly MP, Barclay S. Reassessing advance care planning in the light of covid-19. BMJ. 2020 May 18;369:m1927. doi: 10.1136/bmj.m1927. PMID: 32423988.