Advance health care planning and the GP. is it time to move forward?

AIM: Legislation relating to advance health care planning was introduced into Queensland in 1998. All states and territories apart from Western Australia, New South Wales and Tasmania now have legislation relating to this issue. The aim of this pilot study was to: determine current usage of advance health directives (AHDs) in an individual general practice; and encourage appropriate use of AHDs in general practice. METHOD: One hundred clinical records were audited for evidence of advance health care planning and 100 adult patients were surveyed regarding advance care preferences. RESULTS: One percent of clinical records showed evidence of advance health care discussion and 5% of those surveyed stated they had a current AHD. Only 10% of those surveyed were aware of AHDs; 70% wanted to know more about them; 83% wished family members to be substitute decision makers regarding health matters if the individual was too ill to be involved; 54% nominated doctors to be among their preferred decision makers. CONCLUSIONS: Lack of familiarity with advance health care planning options was very common, however most patients wished to be involved in their own advance health care planning or wished to involve a family member. Legislation now exists in the majority of states and territories for this to occur. General practitioners could assist by having suitable information available in waiting rooms and including discussion in consultations where appropriate.