Respiratory physicians' perceptions and learning needs for advanced care planning in non-malignant respiratory disease: A questionnaire-based survey

<bold>Background:</bold> Advanced care planning (ACP) is crucial for patient-centered care, but its implementation among respiratory physicians (RPs) for patients with non-malignant respiratory diseases (NMRD) remains unclear. <bold>Methods:</bold> A survey was conducted among 174 RPs at Chiba University Hospital and 48 affiliated hospitals, evaluating how ACP for patients with NMRD, including chronic obstructive pulmonary disease (COPD), interstitial pneumonia (IP), chronic respiratory infection, and pulmonary hypertension (PH), was implemented. The barriers and management strategy were also evaluated. <bold>Results:</bold> A total of 88 (50.6%) RPs responded. Among them, 86 (97.7%) had implemented ACP for patients with NMRD, but 67 (76.1%) felt burdened by its practice. In IP patients, ACP was most frequently initiated at diagnosis (30.7%), and 44.3% of respondents considered the timing to be ideal. However, in patients with COPD, chronic respiratory infection, and PH, ACP was most frequently initiated at the unstable clinical phase (29.5%, 35.2% and 22.7%, respectively), and 37.5%, 37.5%, and 26.1% of respondents, respectively, thought that the timing was not ideal. The main barriers to ACP for patients with NMRD were difficulty in predicting disease prognosis, time constraints for RPs, lack of disease awareness among patient and/or families, and lack of interprofessional collaboration for ACP. Finally, 48.9% of respondents required learning opportunities regarding ACP for patients with NMRD. <bold>Conclusions:</bold> While RPs are engaging in ACP for patients with NMRD, not all ACP is ideal. Addressing barriers and enhancing education can optimize ACP for patients with NMRD.