ACP Video Intervention for Patients With Life-Limiting Illness
- Conditions
- End Stage DiseaseHealth Care Utilization
- Interventions
- Behavioral: Home ACP Video
- Registration Number
- NCT04778761
- Lead Sponsor
- Massachusetts General Hospital
- Brief Summary
The goal of this research is to increase patients' knowledge about advance care planning (ACP) discussions and hospice care for patients with serious illness receiving home-based care.
- Detailed Description
ACP is a process that allows patients to communicate their wishes and preferences or medical care, when they are seriously ill, to their medical providers. The study investigators would like to assess whether a home-ACP video can improve patient-clinician communication about patients wishes for their medical care and lead to more patient-centered care.
This study is a randomized clinical trial of a Home-ACP intervention among 500 adult patients with serious illness receiving medical care at home with the Clover Health House Calls Program. Study participants will be assigned to one of two groups. In one group, participants will continue to receive usual care with their home-based care team. In the second group, participants will continue to receive their usual care with their home-based care team and also view an ACP video that helps them understand ACP and provides education about ACP and hospice care.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 500
- Aged 21 or over
- Have a one-year prognosis or less as determined by Clover Health's validated algorithm
- Speak either English or one of the other 25 languages in which the video intervention is available
- Visually impaired beyond 20/200 corrected
- Acute psychiatric illness or other comorbid condition that impairs cognitive ability to participate in advance care planning discussion as determined by the primary House Call Provider.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Video intervention Home ACP Video In addition to usual care, the intervention will entail having a visit by a trained study clinician to provide access to the ACP video. The study clinician will discuss the content of the video and answer any questions.
- Primary Outcome Measures
Name Time Method Hospice utilization up to one year follow-up or death Compare the use of hospice (yes vs. no) between the study groups
- Secondary Outcome Measures
Name Time Method Rates of documented resuscitation preferences in the Electronic Health Record up to one year follow-up or death Compare documented resuscitation preferences in the Electronic Health Record between the two groups
Patient reported satisfaction with clinician communication up to two days following the intervention visit Compare patient satisfaction with their communication with their clinician using the CAHPS subscale. Score range 0-20. Higher score indicate better satisfaction with communication
Patient knowledge about Advance Care Planning Up to two days following the intervention visit Compare patient's knowledge about advance care planning using a 5-item knowledge questionnaire (range 0-5), higher score indicate more knowledge
Patient reported confidence in care up to two days following the intervention visit Compare patient's reported confidence in their medical care using a single Likert response question between the two study groups. Score range from 0-4. Higher scores indicate higher confidence in care
Patient reported decisional certainty up to two days following the intervention visit Compare patient reported decisional certainty between the two groups using the Decision Conflict Scale. Score ranges from 0 to 100. Higher scores indicate higher decisional conflict
Hospice length of stay up to one year follow-up or death Compare hospice length-of-stay between the study groups
Rates of Advance Care Planning documentation in the Electronic Health Record up to one year follow-up or death Compare advance care planning documentation in the Electronic Health Record between the two groups
Patient reported decisional satisfaction up to two days following the intervention visit Compare patient reported decisional satisfaction between the study groups using the Satisfaction with Decision Scale. Scale range from 6-30. Higher scores indicate higher satisfaction with decision
Trial Locations
- Locations (1)
Clover Health
🇺🇸Jersey City, New Jersey, United States