A Review of Advance Care Planning in Research and Clinical Settings

ABSTRACT

Objective: To review the current advance care planning (ACP) in research and clinical settings globally, and identify immediate needs in Japan. Methods: We searched reviews in MEDLINE and original articles in ICHUSHI published up to July 2019, using the Medical Subject Heading (MeSH) thesaurus term ACP; we specifically searched for papers in English or Japanese. Results: We selected 849 reviews from MEDLINE. The majority were published in the United States, and approximately 50 in the United Kingdom. We selected 2,264 articles from ICHUSHI, although 186 were original and there were few reviews. Clearly, there are far fewer ACP publications in Japan than in the US. In Japan, a common concept of ACP is not defined among researchers, medical providers, and the government for Japanese culture and social background. Furthermore, there are limited interventional ACP studies among community-dwelling people, regardless of their use of medical or long-term care services, and despite the Japanese government’s efforts to encourage ACP use. Conclusion: The concept of ACP in the Japanese culture should be identified immediately, and it is essential to provide evidence of the effectiveness of ACP among community-dwelling people. In particular, further ACP studies are needed among people provided with different kinds of home care to help support their satisfaction of end-of-life care, which is a part of community integrated care.