Timing of advance care planning in patients with advanced cancer: Analysis of ACTION data

Tingting Zhu; Judith Ac Rietjens; Johannes J M van Delden; Luc Deliens; Agnes van der Heide; Anna Thit Johnsen; Francesca Ingravallo; Urška Lunder; Nancy J Preston; Jane Seymour; Ida J Korfage

doi:10.1016/j.pec.2025.108761

Timing of advance care planning in patients with advanced cancer: Analysis of ACTION data

Tingting Zhu^*, Judith Ac Rietjens, Johannes J M van Delden, Luc Deliens, Agnes van der Heide, Anna Thit Johnsen, Francesca Ingravallo, Urška Lunder, Nancy J Preston, Jane Seymour, Ida J Korfage

^*Corresponding author af dette arbejde

Klinisk Onkologisk Afdeling

Publikation: Bidrag til tidsskrift › Artikel › Forskning › peer review

Abstract

OBJECTIVE: To explore the experiences of patients with advanced cancer regarding the timing of ACP.

METHODS: This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0-3, and with a minimum life expectancy of 3 months were included in this analysis.

RESULTS: The mean time between patients' cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as "just right" by 217 (75.3 %) of the patients. Patients who perceived the timing as "too early" were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as "too late" had shorter estimated survival times.

CONCLUSION: Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice.

PRACTICE IMPLICATIONS: When initiating ACP conversations, several aspects should be considered, including patients' gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.

Originalsprog	Engelsk
Artikelnummer	108761
Tidsskrift	Patient Education and Counseling
Vol/bind	136
DOI	https://doi.org/10.1016/j.pec.2025.108761
Status	Udgivet, E-publikation før trykning - 24 mar. 2025

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10.1016/j.pec.2025.108761Licens: CC BY

Citationsformater

Zhu, T., Rietjens, J. A., van Delden, J. J. M., Deliens, L., van der Heide, A., Johnsen, A. T., Ingravallo, F., Lunder, U., Preston, N. J., Seymour, J., & Korfage, I. J. (2025). Timing of advance care planning in patients with advanced cancer: Analysis of ACTION data. Patient Education and Counseling, 136, Artikel 108761. Advance online publication. https://doi.org/10.1016/j.pec.2025.108761

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abstract = "OBJECTIVE: To explore the experiences of patients with advanced cancer regarding the timing of ACP.METHODS: This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0-3, and with a minimum life expectancy of 3 months were included in this analysis.RESULTS: The mean time between patients' cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as {"}just right{"} by 217 (75.3 %) of the patients. Patients who perceived the timing as {"}too early{"} were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as {"}too late{"} had shorter estimated survival times.CONCLUSION: Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice.PRACTICE IMPLICATIONS: When initiating ACP conversations, several aspects should be considered, including patients' gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.",

author = "Tingting Zhu and Rietjens, {Judith Ac} and {van Delden}, {Johannes J M} and Luc Deliens and {van der Heide}, Agnes and Johnsen, {Anna Thit} and Francesca Ingravallo and Ur{\v s}ka Lunder and Preston, {Nancy J} and Jane Seymour and Korfage, {Ida J}",

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doi = "10.1016/j.pec.2025.108761",

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volume = "136",

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T1 - Timing of advance care planning in patients with advanced cancer

T2 - Analysis of ACTION data

AU - Zhu, Tingting

AU - Rietjens, Judith Ac

AU - van Delden, Johannes J M

AU - Deliens, Luc

AU - van der Heide, Agnes

AU - Johnsen, Anna Thit

AU - Ingravallo, Francesca

AU - Lunder, Urška

AU - Preston, Nancy J

AU - Seymour, Jane

AU - Korfage, Ida J

PY - 2025/3/24

Y1 - 2025/3/24

N2 - OBJECTIVE: To explore the experiences of patients with advanced cancer regarding the timing of ACP.METHODS: This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0-3, and with a minimum life expectancy of 3 months were included in this analysis.RESULTS: The mean time between patients' cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as "just right" by 217 (75.3 %) of the patients. Patients who perceived the timing as "too early" were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as "too late" had shorter estimated survival times.CONCLUSION: Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice.PRACTICE IMPLICATIONS: When initiating ACP conversations, several aspects should be considered, including patients' gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.

AB - OBJECTIVE: To explore the experiences of patients with advanced cancer regarding the timing of ACP.METHODS: This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0-3, and with a minimum life expectancy of 3 months were included in this analysis.RESULTS: The mean time between patients' cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as "just right" by 217 (75.3 %) of the patients. Patients who perceived the timing as "too early" were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as "too late" had shorter estimated survival times.CONCLUSION: Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice.PRACTICE IMPLICATIONS: When initiating ACP conversations, several aspects should be considered, including patients' gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.

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DO - 10.1016/j.pec.2025.108761

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SN - 0738-3991

VL - 136

JO - Patient Education and Counseling

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M1 - 108761

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Timing of advance care planning in patients with advanced cancer: Analysis of ACTION data

Abstract

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