100 How do community-based palliative care patients in the USA view emergency health care plans?

Background Advance care planning (ACP) improves the quality of life, reduces hospital admissions and increases choice for patients with life limiting conditions. ACP includes advance statements, health care power of attorney and emergency health care plans (EHCPs). They provide concise clinical recommendations for use in an emergency while also aiming to empower patients. There is however no research evaluating the views of palliative care patients on EHCPs. Objectives The objective of this pilot study was to describe the views of community-based palliative care patients in USA on EHCPs. Methods The study was conducted in February 2018 with community based palliative care patients in Greater Cincinnati, Ohio, USA. Patients were recruited if they had completed an EHCP and it had been valid for at least 1 month. There was 2 parts to the study: a written quantitative survey and a face to face interview. The study was approved by the health system’s Institutional Review Board. Results Demographics - 7 out of 10 patients eligible participated in the study (Survey 6 patients, Interview 3 patients). Survey Results 100% patients felt an EHCP guided them during an emergency and they would recommend them to other patients. 100% patients did not share their EHCP with other professionals. Interview Themes: Patients were overwhelmingly positive of EHCPs: they helped in preventing unwanted hospitalisation and aided symptom management. They described the time to write an EHCP as reasonable. Conclusion The results of this study demonstrate that patients use EHCPs to guide their care during an emergency. This reaffirms the place of EHCPs in the advance care planning process. Patients did not share EHCPs with other professionals but this may be due to EHCPs being new to the health system. Finally, as this was a pilot study, further large scale research is required to further determine patients‘ views.