Feasibility of a serious illness communication program for pediatric advance care planning

Feasibility of a serious illness communication program for pediatric advance care planning
JAMA Open Newtwork; Danielle D. DeCourcey, MD, MPH; Rachelle E. Bernacki, MD, MS; Brett Nava-Coulter, MPH; Sithya Lach, BS; Niya Xiong, MSPH; Joanne Wolfe, MD, MPH; 7/24
Children and adolescents and young adults (AYAs) with serious illness often have a variable clinical course with periods of stability alternating with life-threatening deteriorations; consequently, many children and AYAs experience health crises without opportunities to discuss preferences for medical care. Furthermore, bereaved parents report a lack of preparation to address their child’s medical and emotional needs at end of life (EOL). Advance care planning (ACP) is an iterative process to honor patient and family goals and values involving communication about prognosis and the formulation of care plans addressing symptom management, quality of life, preferences for life-sustaining interventions, and anticipatory guidance about EOL. Pediatric advance care planning (ACP), which aims to ensure care is aligned with family goals and values, is associated with better end-of-life outcomes; however, ACP in pediatrics remains uncommon. This pilot cohort study found that the PediSICP [Pediatric Serious Illness Communication Program] was feasible, acceptable, and highly valued by clinicians and parents of children with serious illness.