More online advance directives completed during COVID-19

(HealthDay)—There has been an increase in completion of advance directives (ADs) during the COVID-19 pandemic, according to a research letter published online July 20 in JAMA Network Open.

Catherine L. Auriemma, M.D., from the Palliative and Advanced Illness Research Center at the University of Pennsylvania in Philadelphia, and colleagues conducted a prospective cohort study of users of OurCareWishes.org, designed to guide patients and families through advance care planning (ACP). Monthly rates of AD completion, number of goal-setting modules completed, and distributions of preferences for care were assessed during the pre-COVID-19 period (Jan. 1, 2019, to Jan. 31, 2020) and the COVID-19 period (Feb. 1 to April 30, 2020).

The researchers identified 424 users during the pre-COVID-19 period, with a median of 26, five, and 31 monthly new users, returning users, and total users, respectively. The corresponding medians were 133, 21, and 154 during the COVID-19 period, with a total of 482 users. These numbers represented a 4.9-fold increase in monthly users. During COVID-19, completion rates increased for five of nine optional modules (identifying goals of care, important end-of-life priorities, health state ratings, organ donation, and wishes for one's final days).

"The increased demand for AD documentation might be explained by an increased sense of AD importance owing to COVID-19-induced hospital visitation restrictions, calls for clinicians to promote ACP, or because COVID-19 has provided new motivation for patients who have long wanted to complete ADs but previously failed to do so," the authors write.

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