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1256 A global and comprehensive definition of advance care planning: results of an international Delphi-process

bmjspcare · 2025-09-09 · canonical JSON source

9 visible annotations · policy: published · automated confidence ≥ 75.00%

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Background Advance care planning (ACP) has been firstly mentioned in 1993 and used increasingly since 2010 in scientific literature. Since then several definitions have been published for ACP e.g. for specific groups of people (adults/persons with dementia) and regions (Asia). However, a global, inclusive and comprehensive definition and the structural elements necessary for ACP have not yet been developed, which makes it difficult to classify and compare studies on ACP and ACP programs. However, the ACP-i society considers such a broad definition to be necessary in order to improve the discourse and also the self-determined and person-centered care of patients.Research questions How can ACP be defined globally, inclusively and comprehensively and which design elements must an ACP program have?Methods A Delphi study will be conducted with international ACP experts of all continents with a qualitative and a quantitative part. For the qualitative part (05–08.2025), the experts are asked to add missing aspects to the existing definitions (especially target groups, regional aspects and elements) in a survey (Software: Welphi). The results will be evaluated by thematic analysis using MAXQDA by a group of experts and used for a focus-group workshop at the ACP-i conference 2025. In the quantitative part (01–03.2026), these results will be translated into a second survey. Experts will be invited to rate and validate the results based on their cultural and professional understanding and, if necessary, provide reasons. The number of rounds will depend on the respective outcome.Results The results of the qualitative Delphi study thematic analysis will be presented and discussed at the congress.Discussion The results should enable us to come closer to a comprehensive, global definition of ACP including common core elements. This definition should define different target groups as well as regional aspects and necessary elements that make up an effective ACP program. Based on this definition, ACP programs can be better classified in ACP studies and clinical practice.Unique Contribution The previous ACP Delphi studies provided a step towards unifying select regional consensus definition for certain groups of persons and recommendations. A globally-shared consensus-based comprehensive definition and necessary design elements for ACP programs will support consistent application within multidisciplinary clinical practice, policies, research, and law.Implications This work will significantly impact how ACP interventions are understood and adapted across cultures and better understand how ACP is practiced and conveyed to persons and those important to them in the global context.