Chetna Malhotra, Assistant Professor, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
David Sim Kheng Leng, Fazlur Rehman Jaufeerally, Eric Finkelstein, Yeo Khung Keong, Tan Poh Yong, Nadkarni Nivedita, Genevieve Wong, Tan Boon Cheng, Clarice Ng, Lim Jing Fen, Chuang Ya-Ting
Advance care planning (ACP) is considered to be one of the most promising interventions to enable patients with life limiting illnesses to receive treatment at the end of life according to their own preferences and to
promote and of life conversations between patients and their health care providers. Singapore has launched several pilot programs for ACP, however, the effectiveness of ACP in meeting patient’s end of life care
preferences has never been evaluated in the Asian context.
This study aims to assess whether patients receiving ACP have a greater likelihood of receiving end of life care consistent with their preferences compared to patients receiving usual care. In addition, we also compare
health care expenditures, patient’s understanding of own illness, their participation in decision making, quality of life, anxiety and depression between those receiving ACP and those with usual care.
The design is a randomized control trial (RCT) of ACP versus normal care. A total of 282 patients with Class III and IV heart failure (New York Heart Association Functional Classification) are enrolled. Eligible patients
are recruited and followed for one year or till they die, whichever is earlier, and interviewed every 4 months during this duration. Additionally, the study includes up to 1 caregiver per patient enrolled.
National Heart Centre Singapore
Singapore General Hospital
If benefits of ACP are confirmed via the RCT proposed here, then it will help to promote acceptance of ACP among patients and health care providers across Singapore.
Malhotra C, Sim DKL, Jaufeerally F, Nadkarni N, Wong GCS, Tan BC, Ng CSH, Tho PL, Lim J, Chuang CYT, Fong FHM, Liu J, Finkelstein EA. Trials. 2016; 17(1):285.
Project Start Date:
1 February 2015