Advance care planning helps teens with cancer

A family-centered advance care planning (ACP) intervention for adolescent oncology patients rendered these youths significantly better informed than those who didn't participate in such sessions.

A total of 60 adolescents, aged 14 to 21 years (mean age 16 years), with leukemia, brain tumor, solid tumor, or lymphoma were enrolled in the randomized controlled trial along with their families or surrogates. Half the youths had three sessions of family-centered ACP intervention. They completed the Lyon Family-Centered ACP Survey, the Respecting Choices interview, and Five Wishes. The other half of the patients received standard care: They were given brochures containing ACP information, but did not have the facilitated conversations.

The intervention adolescents were found to be significantly better informed than their standard-care counterparts about end-of-life decisions, and intervention families were more likely to concur on limiting treatments than were the standard-care families.

All of the adolescents in the intervention wanted their families to do what was best at the time, whereas only 62% of the standard-care youths gave their families this leeway.

“Advance care planning enabled families to understand and honor their adolescents' wishes,” concluded Maureen E. Lyon, PhD, and colleagues in JAMA Pediatrics.

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