Intervention to Promote Advance Care Planning for Older Adults in the Emergency Department
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 42
- 主要终点
- Documentation of end-of-life preferences in the electronic health record
研究概览
简要总结
There is an urgent need to increase advance care planning among older adults in order to ensure that patients receive care of the end of life that is consistent with their values and preferences. Emergency departments (EDs) provide an opportunity to reach a large proportion of older adults who have not yet completed advance care planning at a time when they are likely to recognize the need for such planning. The purpose of this pilot is to examine the potential of a video-supported intervention initiated during the emergency department visit to promote advance care planning.
详细描述
The overarching goal of this project is to understand the impact of an ED-initiated intervention on the promotion of advance care planning (ACP) among older adults. Participants are given either a short informational handout on the process and choices involved in ACP or watch a 6-minute video about ACP. The video describes cardiopulmonary resuscitation (CPR), breathing tube placement, and mechanical breathing support in addition to the general process of ACP. Following the video, patients in the intervention will also have an email sent to their primary care provider. The email will inform the primary care provider that the patient has watched a video about ACP, include a brief synopsis of the video, and provide instructions as to how to document the patient's preferences in the hospital's electronic health record in a way that will be accessible to other providers. Outcomes will include documentation of end-of-life care preferences in the electronic health records and patient-reported conversation with their provider as well as conversations with loved ones.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
盲法说明
All patients and researchers are aware if the patient receives a handout or watches the ACP video.
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Ability to provide informed consent
- •Ability to communicate in English
- •Age 65-79 years with a serious medical illness: (1) Established diagnosis of metastatic cancer, advanced heart failure, chronic obstructive lung disease, end stage liver disease, end stage renal disease, (2) Unable to walk or requires human assistance with walking, (3) Two hospitalizations within the last 6 months
- •Age 80 years or older
排除标准
- •Critically ill (emergency severity index = 1)
- •Cognitively impaired based on Six Item Screener < 4 or lack the capacity to consent
- •Currently enrolled in hospice or comfort care program
- •No working phone number
- •Non English speaker
研究组 & 干预措施
Control Arm
Participants receive a short informational handout on the process and choices involved in advance care planning.
Intervention
Participants are shown a 6-minute video that describe CPR, breathing tube placement, and mechanical breathing support in addition to the general process of advance care planning.
干预措施: Educational Video (Behavioral)
Intervention
Participants are shown a 6-minute video that describe CPR, breathing tube placement, and mechanical breathing support in addition to the general process of advance care planning.
干预措施: Primary Care Provider Email (Behavioral)
结局指标
主要结局
Documentation of end-of-life preferences in the electronic health record
时间窗: 3 months
Since the ED visit, does the patient have any new preferences about CPR, intubation, or palliative care documented in their electronic health record?
次要结局
- Conversation with Loved One(3 months)
- Conversation with Regular Provider(3 months)