Multiprofessional Advance Care Planning and Shared Decision-making for End of Life Care MAPS Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Zurich
- Enrollment
- 115
- Locations
- 1
- Primary Endpoint
- end of life wish on resuscitation known (if alive) or fulfilled(if dead) after 6 month by responsible physician and/or surrogate decision maker (SM)
Study Overview
Brief Summary
Multiprofessional Advance Care Planning and shared decision making for end of live care for terminal patients and their relatives.
The aim of this study is to develop, implement and test a complex intervention for improving patients' preparation for and participation in end of life decisions. In cooperation with local, national and international partners, the investigators will focus on strategies to enhance advance care planning and shared decision making on end of life issues, and documentation and transferability of end of life decisions across health care settings in coordinated approach involving patients, their families and care givers (in and out of hospital).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- Triple (Participant, Care Provider, Investigator)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •patients in which the treating physician on the ward would not be surprised if the patient died during the next year (surprise question of Weissman et al 2011)
- •male and female patients above 18 years of age
- •signed informed consent after being informed
- •patients able to appoint a surrogate decision maker (SM) and/or responsible physician to be contacted after discharge
Exclusion Criteria
- •patients not capable of speaking german
- •patients having no responsible physician to be contacted after discharge and no relative/future surrogate decision maker (SM)
- •inhouse patients being discharged within the next 2 days or ambulatory patients not regularly coming to the wards (at least every two month)
- •patients assessed by their physician to be in obvious denial of their situation (illness/prognosis)
Arms & Interventions
Control Group
A routine care discharge planning with the social service
Intervention: Control Group (Other)
Advance Care Planning ACP
Patient get a decision aid video and library and up to 3 consultations with qualified Advance Care Planning Facilitators.
Intervention: Advance Care Planning ACP (Other)
Outcomes
Primary Outcomes
end of life wish on resuscitation known (if alive) or fulfilled(if dead) after 6 month by responsible physician and/or surrogate decision maker (SM)
Time Frame: during 2 weeks six months after discharge
Secondary Outcomes
- Having an Advance directive(at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge)
- Having an appointed surrogate decision maker(at discharge, during 2 weeks three month after discharge and during 2 weeks six month after discharge)
- Treatment against patients wishes(during 2 weeks three months after discharge and during 2 weeks six months after discharge, or 3 month after death)
- Distress of Patients or relatives because of content of the consultation(at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge)
- Hospital Anxiety and Depression scale ("HADS")(discharge and during 2 weeks six months after discharge)
- end of live decisions on last place of care, antibiotics for pneumonia, feeding tube, intravenous fluids, dialysis, intubation and sedation,(during 2 weeks six months after discharge)
- decisional conflict scale ("DCS"), O Connor et al 1995(at discharge and during 2 Weeks six months after discharge)
- Satisfaction with information and care, (see Detering et al 2010)(at discharge)
- Any hospital stay(during 2 weeks three months after discharge and during 2 weeks six months after discharge)
- open question on important medical decisions being made(during 2 weeks three months after discharge)
- Decisions regarding end of life issues already having been made/taken place(during 2 weeks six months after discharge)