理学療法ジャーナル57巻10号

2023年10月発行

特集 ACP—個人の人生史を尊重し受け入れる

ACP（Advance Care Planning；アドバンス・ケア・プランニング）—より豊かな医療者-患者関係を築くための実践のすすめ

著者： 木澤義之¹

所属機関： ¹筑波大学医学医療系（緩和医療学）

ページ範囲：P.1160 - P.1164

Point

●アドバンス・ケア・プランニング（advance care planning：ACP）とは本人の価値観を今後の治療やケアに反映させるための話し合いである

●ACP開始のタイミングとその話し合いの内容は，本人の準備状態に合わせて行う

●患者の意向を家族などが代弁できるように，患者-家族間の話し合いを促進するとよい

参考文献

1）厚生労働省：人生の最終段階における医療・ケアの決定プロセスに関するガイドライン．2018．https://www.mhlw.go.jp/file/04-Houdouhappyou-10802000-Iseikyoku-Shidouka/0000197701.pdf（2023年8月1日閲覧）

2）Miyashita J, et al：Culturally adapted consensus definition and action guideline：Japan's advance care planning. J Pain Symptom Manage 2022；64：602-613

3）宮下　淳：日本版アドバンス・ケア・プランニングの定義及び行動指針．日エンドオブライフケア会誌2023；7：2-7

4）Connors AF, et al；The SUPPORT Principal Investigators：a controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments（SUPPORT）. JAMA 1995；274：1591-1598

5）Teno JM, et al：Do advance directives provide instructions that direct care? SUPPORT investigators. Study to understand prognoses and preferences for outcomes and risks of treatment. J Am Geriatr Soc 1997；45：508-512

6）Covinsky KE, et al：Communication and decision-making in seriously ill patients：findings of the SUPPORT project. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. J Am Geriatr Soc 2000；48（S1）：S187-S193

7）Brett AS：Limitations of listing specific medical interventions in advance directives. JAMA 1991；266：825-828

8）Teno JM, et al：Role of written advance directives in decision making：insights from qualitative and quantitative data. J Gen Intern Med 1998；13：439-446

9）Perkins HS：Controlling death：the false promise of advance directives. Ann Intern Med 2007；147：51-57

10）Teno J, et al：Advance directives for seriously ill hospitalized patients：effectiveness with the patient self-determination act and the SUPPORT intervention. SUPPORT Investigators. Study to understand prognoses and preferences for outcomes and risks of treatment. J Am Geriatr Soc 1997；45：500-507

11）Danis M, et al：A prospective study of advance directives for life-sustaining care. N Engl J Med 1991；324：882-888

12）Schaden E, et al：The role of advance directives in end-of-life decisions in Austria：survey of intensive care physicians. BMC Med Ethics 2010；11：19. doi：10.1186/1472-6939-11-19

13）Brinkman-Stoppelenburg A, et al：The effects of advance care planning on end-of-life care：a systematic review. Palliat Med 2014 Sep；28：1000-1025

14）Jimenez G, et al：Overview of systematic reviews of advance care planning：summary of evidence and global lessons. J Pain Symptom Manage 2018；56：436-459.e25. doi：10.1016/j.jpainsymman.2018.05.016

15）McMahan RD, et al：Deconstructing the complexities of advance care planning outcomes：what do we know and where do we go? A scoping review. J Am Geriatr Soc 2021；69：234-244

16）Bernacki R, et al：Effect of the serious illness care program in outpatient oncology：a cluster randomized clinical trial. JAMA Intern Med 2019；179：751-759

17）Malhotra C, et al：What is the evidence for efficacy of advance care planning in improving patient outcomes? A systematic review of randomised controlled trials. BMJ Open 2022；12：e060201. doi：10.1136/bmjopen-2021-060201

18）Johnson S, et al：Advance care planning for cancer patients：a systematic review of perceptions and experiences of patients, families, and healthcare providers. Psychooncology 2016；25：362-386