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    Research Letter
    July 20, 2020

    Completion of Advance Directives and Documented Care Preferences During the Coronavirus Disease 2019 (COVID-19) Pandemic

    Author Affiliations
    • 1Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania, Philadelphia
    • 2Department of Medicine, University of Pennsylvania, Philadelphia
    • 3Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
    • 4Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia
    • 5Center for Health Care Innovation, University of Pennsylvania, Philadelphia
    • 6Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
    JAMA Netw Open. 2020;3(7):e2015762. doi:10.1001/jamanetworkopen.2020.15762

    Fewer than one-third of US residents have completed an advance directive (AD) to guide care when seriously ill.1 Clinician-focused efforts to increase AD completion, such as Medicare payments for advance care planning (ACP), have been ineffective.2 In contrast, patient-facing interventions that enable independent completion of ADs show early promise.3 Self-service platforms also reveal changes in demand for ADs and preferences for future care. We sought to quantify changes in patient completion of ADs and expressed preferences during the coronavirus disease 2019 (COVID-19) pandemic by monitoring users of a web-based AD platform from January 2019 to April 2020.