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Attitudes to earlier advance care planning: a qualitative interview study in general practice

Title: Attitudes to earlier advance care planning: a qualitative interview study in general practice
Authors: Bushell, Sonya; Winter-Luke, Ishbel; Dennis, Elizabeth; Murtagh, Fliss Em
Publisher Information: Royal College of General Practitioners
Publication Year: 2026
Collection: University of Hull: Repository@Hull
Subject Terms: advance care planning; chronic disease; general practice; palliative medicine; public health; qualitative research
Description: Background Advance care planning (ACP) research has often focused on those experiencing deteriorating health. There is limited research regarding attitudes to early ACP among people living with long-term conditions without advanced illness or severe frailty.Aim To explore how people living with a non-cancer long-term condition understand ACP; and their preferences for how, if at all, these discussions should be undertaken, including within annual health reviews.Design and setting Qualitative interviews undertaken with participants from general practices in village, market town, coastal town, and city settings within England, UK.Method The interviews were semi-structured and in depth. The inclusion criteria were: >18 years old; registered at a participating practice; living with cardiovascular disease, diabetes mellitus, kidney disease, or chronic obstructive pulmonary disease. Thematic analysis used a critical realist approach. Participants contributed to a member checking process. This study had NHS ethics approval (23/PR/0078).Results In total, 21 participants were recruited who were aged 61–91 years, eight were men, and 17 participants were living with multimorbidity. Participants discussed three forms of ACP: proactive planning, preparing for change, and discussing the end of life. Participants described early ACP as less distressing. Participants perceived ACP as an ongoing process, with early consultations encouraging discussion of existing preferences and preparing people for future decision making. Participants discussed how ACP could facilitate proactive and person-centred health care. Participants described the importance of normalising ACP.Conclusion This study suggests that ACP may be well received and could be discussed earlier with adults living with long-term conditions, before onset of advanced illness or severe frailty.
Document Type: article in journal/newspaper
Language: English
Relation: https://hull-repository.worktribe.com/output/5536776; British Journal of General Practice the Journal of the Royal College of General Practitioners; Volume 76; Issue 763; Pagination e132-e140
DOI: 10.3399/BJGP.2025.0393
Availability: https://hull-repository.worktribe.com/file/5536776/1/Published%20Article; https://hull-repository.worktribe.com/output/5536776; https://doi.org/10.3399/BJGP.2025.0393
Rights: openAccess ; http://creativecommons.org/licenses/by/4.0
Accession Number: edsbas.74AF7AA9
Database: BASE