Advance care planning in neurological disease to improve end-of-life care and reduce healthcare utilisation…

Cohort studyBMJ supportive & palliative care· Jul 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

NeurologyCohort studyClinical practiceQ2IF 2.2

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 … Alvaro Gandara

BMJ supportive & palliative care · Jul 2026 · Q2 in General Medicine

Purpose

To evaluate the first year of a neurologist-led Advance Care Planning (Advance Care Planning) 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 Advance Care Planning 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

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.

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Conclusion · 1 of 2

A neurologist-led Advance Care Planning 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.

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

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

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