Increasing the Uptake of Advanced Directives in SingHealth Polyclinics
- Conditions
- Advanced Medical Directive, a Legal Document Signed in Advance to State Healthcare Preferences
- Registration Number
- NCT03499847
- Lead Sponsor
- SingHealth Polyclinics
- Brief Summary
An Advanced Medical Directive (AMD) is a legal document in Singapore that allows one to inform their medical practitioner that they do not want any life-sustaining treatment should they become unconscious and terminally ill where death is imminent. Despite the AMD act being passed in Singapore Parliament in 1996, uptake remains low among the population. Several intervention studies have shown that education and communication can be effective in promoting end-of-life discussion and planning. In this study, we aim to compare the effectiveness of counselling sessions together with pamphlets, versus pamphlets alone, versus current care, in increasing the completion rates of the AMD in the Singapore Polyclinic setting.
- Detailed Description
An Advanced Medical Directive (AMD) is a legal document in Singapore that allows one to inform their medical practitioner that they do not want any life-sustaining treatment should they become unconscious and terminally ill where death is imminent. It may be completed by any person, of sound mind, aged 21 years and above.The AMD Act was passed in the Singapore Parliament in May 1996.
A cross-sectional, community-based study surveyed 1200 selected households in Singapore. Only 37.9% of the sample population had heard of the AMD prior to the study, though when approached, 60.6% were willing to sign an AMD. As of 2017, less than 25,000 people (0.45%) in Singapore have opted to sign an AMD.
Past studies have shown that end of life discussions reduce stress, anxiety, and depression in surviving relatives. A local study in 2010 revealed a 33% patient-surrogate discrepancy in end-of-life decision making.
There are a lack of intervention studies regarding AMD in Singapore. In this study, we aim to compare the effectiveness of counselling sessions together with pamphlets, versus pamphlets alone, versus current care, in increasing the completion rates of the AMD in the Singapore Polyclinic setting.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 189
- Age > 40
- Patient who seeks medical consultation at Singhealth Polyclinics (Bedok, Marine Parade, Outram, Tampines)
- History of dementia
- History of depression
- Known diagnosis of terminal illness
- Signed Advanced Medical Directive/Advanced Care Plan previously
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Number of patient who expressed interest to complete the Advanced Medical Directive 4 months Number of patients who completed the Advanced Medical Directive 4 months
- Secondary Outcome Measures
Name Time Method Barriers to completion of the Advanced Medical Directive 4 months
Trial Locations
- Locations (4)
Outram Polyclinic
🇸🇬Singapore, Singapore
Marine Parade Polyclinic
🇸🇬Singapore, Singapore
Bedok Polyclinic
🇸🇬Singapore, Singapore
Tampines Polyclinic
🇸🇬Singapore, Singapore
Outram Polyclinic🇸🇬Singapore, Singapore