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Advance Care Planning on a Specialist Dementia Unit
J.R. Butler, Asli Ozcivan, Tharun Zacharia. BJPsych Open, 2025-06-01
Topic: Risk, prevention and care in population studies
Number of patients on the unit with an ACP increased between May 2024 and January 2025, from a low of 0% on 03/06/24 to a high of 53% on 12/12/24. Initial ACP discussions offered increased from 27% (20/05/24) to 93% (28/01/25). After introducing the weekly ACP slot, 41% slots were filled. 48% of dementia patients had an ACP by discharge. 50% patients with an estimated <12-month prognosis had an ACP by discharge. By January 2025, 100% prognostic coding was communicated to the GP. The weekly timeslot increased the number of ACPs. Improved identification of patients resulted in approximately half of dementia patients, and half of patients with a prognosis of months, having an ACP by discharge. Challenges included embedding ACP meetings into routine practice. Recommendations: Gather feedback from patients and carers – case studies suggested ACP discussions were well received by carers and positively impacted patient care. Continue the regular weekly ACP slot. Provide more staff training. Audit outputs of ACP discussions.
Key findings
- Number of patients on the unit with an ACP increased between May 2024 and January 2025, from a low of 0% on 03/06/24 to a high of 53% on 12/12/24.
- Initial ACP discussions offered increased from 27% (20/05/24) to 93% (28/01/25).
- After introducing the weekly ACP slot, 41% slots were filled. 48% of dementia patients had an ACP by discharge. 50% patients with an estimated <12-month prognosis had an ACP by discharge.
- By January 2025, 100% prognostic coding was communicated to the GP.
- The weekly timeslot increased the number of ACPs.
Why it matters
This quality improvement project on a specialist dementia unit increased the proportion of patients with an advance care plan by introducing a weekly ACP slot. It is about end-of-life planning in care, not treating, curing or preventing Alzheimer's disease.
Study details
- Participants67
- Evidence strengthLow
How this study scored 30/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BJPsych Open) |
| Journal's citation record | 1 / 4 | BJPsych Open: journal h-index 75 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 67 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 0 / 4 | Last-listed author Tharun Zacharia: h-index 2 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | South London and Maudsley NHS Foundation Trust: institution h-index 347 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 30 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Butler, J., Ozcivan, A., & Zacharia, T. (2025). Advance Care Planning on a Specialist Dementia Unit. BJPsych Open. https://doi.org/10.1192/bjo.2025.10345
Vancouver
Butler J, Ozcivan A, Zacharia T. Advance Care Planning on a Specialist Dementia Unit. BJPsych Open. 2025. doi:10.1192/bjo.2025.10345.
BibTeX
@article{butler2025-aaafbccb,
author = {Butler, J.R. and Ozcivan, Asli and Zacharia, Tharun},
title = {{Advance Care Planning on a Specialist Dementia Unit}},
journal = {BJPsych Open},
year = {2025},
doi = {10.1192/bjo.2025.10345},
url = {https://doi.org/10.1192/bjo.2025.10345}
}
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