A Community-based Advance Care Planning Programme to Improve End-of-life Care in Patients With Advanced Disease: A Mixed-method Approach
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Chronic Disease
- Sponsor
- Food and Health Bureau, Hong Kong
- Enrollment
- 239
- Locations
- 1
- Primary Endpoint
- End-of-life care preferences
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
Advance care planning has been recommended as an integral part of care for patients with life-limiting disease, but relevant development in Hong Kong is still in its infancy. This proposed study attempts to address this service gap by promoting advance care planning to patients with advanced disease. It is hypothesized that the proportion of patients whose end-of-life care preferences were known in the experimental group will be significantly higher than that in the control group.
Detailed Description
This study aims to evaluate the impacts of a community-based advance care planning programme on end-of-life care of patients with advanced disease. A mixed-method approach, including a randomized controlled trial and qualitative interviews, will be used. Participants in the experimental group will received a structured advance care planning programme delivered by a trained facilitator. It includes an educational component, reflection and a family meeting.
Investigators
Dr. Helen YL Chan
Associate Professor
Chinese University of Hong Kong
Eligibility Criteria
Inclusion Criteria
- •aged 18 or above
- •meet one of the three triggers for supportive /palliative care as suggested in the Gold Standards Framework
- •living at home
- •being communicable
Exclusion Criteria
- •mentally incompetent
- •cannot nominate a family carer
- •have already signed an advance directive
- •have been referred to palliative care service
Outcomes
Primary Outcomes
End-of-life care preferences
Time Frame: 6 months
In this study, end-of-life care preferences include goal for end-of-life care and decisions over the use of life-sustaining treatments relevant to individual's anticipated health changes. So, whether the patients' end-of-life care preferences is known at different timepoints will be determined based on (1) the congruence between patients' end-of-life care preferences and family carers' predicted end-of-life care preferences for patients; and (2) whether patients' end-of-life preferences are documented in their medical record.
Secondary Outcomes
- Level of certainty about future care(6 months)
- Health care utilization(6 months)