MedPath

Group Advanced Care Planning Pilot for Veterans

Not Applicable
Not yet recruiting
Conditions
Cancer
Registration Number
NCT06646614
Lead Sponsor
Stanford University
Brief Summary

The proposed research aims to engage participants with an advanced stage cancer diagnosis in group educational sessions to facilitate learning of topics related to advanced care planning. The investigators also hope to learn if conducting educational sessions in a group setting helps to create a more supportive environment amongst patients, caregivers, etc.

Detailed Description

The purpose of this study is to compare usual care against a group advanced care planning intervention comprised of two sessions led by trained community health workers or health educators from VA Palo Alto. A total of 50 participants will be randomly assigned to either usual care (n=25) or usual care + group advanced care planning intervention (n=25). Those in usual care will be mailed some educational materials about advanced care planning that they may review independently. Those in the group advanced care planning arm will participate in two 1-hour educational sessions led by the community health worker/educator that will be on site, by VA-approved video conference, or a hybrid model. Topics will include an introduction to advanced care planning, goals of care topics, advance directives, and physicians order of life sustaining treatment. Both usual care and the group advanced care planning arms will also participate in pre/post surveys and/or interviews.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  1. All patients >18 years old with newly diagnosed advanced cancer are eligible.
  2. Patients must have the ability to understand and willingness to provide verbal consent
  3. Participants must speak English
Exclusion Criteria
  1. Inability to consent to the study
  2. Plans to change oncologist within 4 months
  3. Employed by the practice site
  4. Patients who anticipate moving from the area within 4 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Goals of Care DocumentationBaseline and Week 8 after patient enrollment

Documentation of goals of care discussions will be analyzed for each patient at Baseline and Week 8 after enrollment.

Secondary Outcome Measures
NameTimeMethod
Hospitalization Visits (Self-reported and Chart Review)Week 8 after patient enrollment

Hospital use for each patient will be self-reported by each patient or abstracted by electronic medical record at Week 8.

Total Cost (Self-reported and Chart Review)Week 8 after patient enrollment

Total cost use will be analyzed for each patient at Week 8.

End-of-life Acute Care Facility Death (Chart Review)30 days prior to death

Acute Care Facility Deaths for each patient will be abstracted by electronic medical record chart review and claims review for each patient who has died. We will evaluate comparisons of Acute Care Facility Deaths between study arms.

Change in patient activation using the Patient Activation MeasureBaseline and Week 8 after patient enrollment

Each patient will receive a validated patient activation survey (PAM-13) to assess their activation. This is a validated measure from Insignia Health. Responses are: disagree strongly, disagree, agree, agree strongly with higher activation correlated with responses of agree and agree strongly. Each item is rated on 4-point scale (1 strongly disagree to 4 strongly agree, with additional "not applicable" option). Higher scores indicate greater patient activation. It will be analyzed for each patient at Baseline and Week 8.

Palliative Care Use (Self-reported and Chart Review)Week 8 after patient enrollment

Palliative care use will be analyzed for each patient at Week 8.

Hospice Care Use (Self-reported and Chart Review)Week 8 after patient enrollment

Hospice care use will be analyzed for each patient at Week 8.

Trial Locations

Locations (1)

VA Palo Alto

🇺🇸

Palo Alto, California, United States

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