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New research · Neurology
BMJ supportive & palliative care · 2d
Cohort studyBMJ supportive & palliative care · 2026

Advance care planning in neurological disease to improve end-of-life care and reduce healthcare utilisation: cohort study.

Ivana Zamarbide Capdepón, Eduardo Garcia Romo, Bernadette Pfang … Alvaro Gandara
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NeurologyCohort study

Advance care planning was associated with fewer emergency department visits.

Advance care planning in neurological disease to improve end-of-life care and reduce healthcare utilisation: cohort study.

Ivana Zamarbide Capdepón et al. · BMJ supportive & palliative care · 2026
Purpose

To evaluate the first year of a neurologist-led Advance Care Planning (ACP) consultation implemented within a tertiary hospital neurology department, and to assess its impact on end-of-life (EOL) care, alignment with patient preferences, and healthcare utilisation among patients with advanced neurological disease.

Methods

A retrospective observational study of all patients referred to a specialised ACP consultation between May 2023 and June 2024 at the Fundación Jiménez Díaz University Hospital (Madrid, Spain).

Results

fewer patients had emergency department visits after advance care planning

48%
Before
22%
After
More results

Severe cognitive impairment (68%) and moderate-severe dependency (88%) were common.

Communication limitations affected 38%.

Engagement with palliative care teams occurred in 24%, and 47% used Web Dialogue.

More results

Thirty-two patients (37%) died during follow-up; 66% died in their preferred location.

“
Conclusion · 1 of 2

A neurologist-led ACP consultation is feasible and improves key EOL outcomes for patients with advanced neurological disease, including reduced acute care use and greater alignment with patient preferences.

Conclusion · 2 of 2

This model may support broader integration of palliative principles within neurology services.

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