Advance care planning and home death in patients with advanced cancer: a structured interview analysis.

Background:: Discrepancy between preferred and actual place of death is common in patients with advanced cancer.

Aim:: To investigate the association between advance care planning (ACP) and home death in patients with advanced cancer.

Methods:: Using structured interviews, 44 primary nurses from 19 home-visit nursing agencies in Japan were asked about status changes for 123 advanced cancer patients receiving home care. The main outcome was the place of death.

Results:: Of the 123 patients, 16 were alive, 54 died at home and 53 died at hospital. Multivariate analyses revealed that home death was more likely if: i) physicians or nurses practised ACP during the whole home-visit period (odds ratio (OR) 41.76; confidence interval (CI) 5.87-297.07); ii) patients had adequate insight concerning their prognosis just before death or at hospitalisation (OR 7.85; CI 1.18-52.24); and iii) the baseline preference of families was a home death (OR 0.09; 95% CI 0.01-0.73).

Conclusion:: ACP practiced by physicians or nurses for advanced cancer patients may contribute to achieving home death.