Introduction: Japan is not only an aging society, but also a society with a high death rate, and end-of-life care is an urgent issue, as well as support for the lives of the elderly. Advance Care Planning is one of the important decision-making supports for maintaining and improving the quality of life (QOL) and quality of dying and death of patients. Therefore, this study will investigate the implementation status and issues of ACP in primary care facilities in Japan. Methods: A cross-sectional survey study in which 1444 facilities of home care support clinics in Japan were randomly selected. Results: One hundred-eleven responses (7% response rate) were received, with a valid response rate of 100%. Seventy-three facilities (65.7%) were implementing ACP and 38 (34.2%) were not. The support needed for implementation was prioritized as knowledge, information and understanding of the people involved. Reasons for difficulties in implementation included lack of knowledge, skills and experience of medical professionals and lack of understanding of patients and their families. Conclusion: With 37.8% of participants not having received training and 34% not implementing ACP, it cannot be said that implementation of ACP is widespread in primary care domain. Lack of knowledge and skills regarding ACP and difficulty in finding time are issues for the implementation and continuation of ACP, and the need for support in terms of opportunities to attend training and provision of specific information at a practical level was suggested.
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