Advance Care Planning: We Need to Change Our Approach to Improve Patient and Clinician Engagement

Advance care planning (ACP) is the process of evaluating and defining goals and preferences for future medical treatment and care. ACP enables these discussions with care partners and health care professionals and records and revises preferences when appropriate (1). ACP can facilitate health and care planning conversations between patients and clinicians, support patient autonomy and provide clarity for family members and surrogate decision makers in treatment decision making. However, in kidney care, the prevalence of completed ACPs in dialysis patients remains worryingly low, estimated at 2.8% in one Australian study auditing over 1000 medical records (2).