title: Advance directives: survey of primary care patients.
abstract: OBJECTIVE
  To establish the prevalence of patients with advance directives in a family practice, and to describe patients' perspectives on a family doctor's role in initiating discussions about advance directives.
  
  
  METHODS
  A self-administered patient questionnaire.
  
  
  METHODS
  A busy urban family medicine teaching clinic in Hamilton, Ont.
  
  
  METHODS
  A convenience sample of adult patients attending the clinic over the course of a typical business week.
  
  
  METHODS
  The prevalence of advance directives in the patient population was determined, and the patients' expectations regarding the role of their family doctors were elucidated.
  
  
  RESULTS
  The survey population consisted of 800 participants (a response rate of 72.5%) well distributed across age groups; 19.7% had written advance directives and 43.8% had previously discussed the topic of advance directives, but only 4.3% of these discussions had occurred with family doctors. In 5.7% of cases, a family physician had raised the issue; 72.3% of respondents believed patients should initiate the discussion. Patients who considered advance directives extremely important were significantly more likely to want their family doctors to start the conversation (odds ratio 3.98; P < .05).
  
  
  CONCLUSIONS
  Advance directives were not routinely addressed in the family practice. Most patients preferred to initiate the discussion of advance directives. However, patients who considered the subject extremely important wanted their family doctors to initiate the discussion.
authors: Practising family physician and emergency physician in Hawkesbury, Ont, and Sioux Lookout, Ont. rory.osullivan@medportal.ca.
authors: Rory
authors: R
authors: O'Sullivan
authors: Practising emergency physician in Edmonton, Alta.
authors: Kevin
authors: K
authors: Mailo
authors: Researcher at McMaster University in Hamilton, Ont.
authors: Ricardo
authors: R
authors: Angeles
authors: Clinician researcher and Associate Professor of Family Medicine at McMaster University.
authors: Gina
authors: G
authors: Agarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D032722:Advance Care Planning / Q000941:ethics* / Q000592:standards; D016223:Advance Directives / Q000941:ethics / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000941:ethics / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D010817:Physician-Patient Relations / Q000941:ethics*; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods*; D055815:Young Adult