Recent polls suggest that 60% of Canadians want to have important end-of-life conversations with their doctors, however a large number of health professionals don’t feel equipped to have these important discussions. A new study — Improving General Practice Advance Care Planning (i-GAP) — is aiming to find strategies and tools to bridge that gap and get people talking.
“We know from previous research that advance care planning (ACP), a process of communicating your wishes for care and naming a substitute decision maker who can speak for you if you cannot, results in more positive end of life experiences for patients, families and health professionals,” says Dr. Michelle Howard, a Principal Investigator for i-GAP. “We need to better understand the barriers to ACP and what tools are needed to facilitate these conversations.”
A 2014 Ipsos Reid survey of General Practitioners, Family Practitioners and Nurses in Primary Care reports that only 26% of physicians are very comfortable discussing ACPs with patients, and one-quarter of physicians/nurses across Canada know little or next to nothing about ACP. 67% of physicians indicate that they need more resources and information to have these discussions with their patients.
A previous Harris/Decima poll suggests that Canadians overwhelmingly want their health care provider to give them information about advance care planning.
Researchers and partners in the study will develop and evaluate various ACP tools and strategies in primary care settings across Canada. The Canadian Hospice Palliative Care Association’s (CHPCA) Advance Care Planning in Canada Initiative is partnering with CARENET (Canadian Researchers at the End of Life Network) and i-GAP to implement the project and will translate the knowledge gained from the study into tools that can be accessed and distributed through its national Speak Up campaign website (www.advancecareplanning.ca).
The i-GAP study includes researchers from McMaster University, Queen’s University, the University of Alberta and the University of British Columbia. Along with the Canadian Hospice Palliative Care Association’s Advance Care Planning in Canada Initiative, the research team has partnered with primary care practitioners in 12 ‘incubator units’ across Canada. Other partners include the College of Family Physicians of Canada, the Canadian Foundation for Healthcare Improvement, the Ontario Medical Association, Hospice Palliative Care Ontario, provincial Colleges of Family Physicians, and the ACP CRIO (Collaborative Research and Innovation Opportunities). Funding sources include the Canadian Institutes of Health Research (CIHR) and TVN (Technology Evaluation in the Elderly Network).
For more information about CHPCA’s Advance Care Planning in Canada Initiative and the Speak Up campaign, or to access i-GAP investigators, please contact: Tamir Virani at 1-800-668-2785 ext. 229 or by email at:TVirani@bruyere.org.
 “The Way Forward Survey: General/Family Practitioners and Nurses in Primary Care”, is a survey that included both qualitative and quantitative phases. Focus groups and ideation sessions took place in three urban centres (Calgary, Toronto, Montreal) and three rural regions (east, north, west). The online survey portion was completed for the Canadian Hospice Palliative Care Association using a healthcare provider partner panel. The online survey of 286 general practitioners/family physicians and 200 nurses in primary care across Canada was conducted between April 24 and May 12, 2014. Overall data has been weighted to reflect true region distribution.
 “What Canadians Say: The Way Forward Survey Results”, is a quantitative online research survey of 2,976 Canadian adults. The poll was completed for the Canadian Hospice Palliative Care Association using the Harris/Decima’s proprietary online panel and is precluded from reporting a margin of error. The survey data was weighted using the 2011 Census to reflect the general population.