A Randomized Trial to Encourage Older Adults and Adults With Serious Illness to Designate a Health Care Proxy
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 20,000
- 试验地点
- 1
- 主要终点
- Proportion of patients with EHR-documented healthcare proxy
研究概览
简要总结
This study is a Stage III randomized trial to encourage patients in advance of a health care appointment to designate a healthcare proxy. Patients will be randomly assigned to receive a mailer containing information about designating a healthcare proxy, or to not receive any mailer. For patients assigned to receive a mailer, the mailer will differ by the presence or absence of a patient pre-commitment prompt, and contain a personalized provider request or a generic health system request. The work will evaluate the randomized trial and identify factors that predict intervention effectiveness.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Health Services Research
- 盲法
- None
盲法说明
Hospital staff, including clinicians, will not be alerted to the patient's assigned intervention. However, clinicians may learn of the patient's assigned intervention if the patient brings their mailer to the visit.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •No EHR-documented healthcare proxy at enrollment
- •Age ≥ 55 years OR age ≥ 18 years and listed in the health system's cancer, CHF, or CKD registries
排除标准
- •Primary care provider not assigned at time of randomization.
研究组 & 干预措施
No Mailer Control
Patients will not receive a mailer.
Provider Mailer with a Pre-commitment Prompt
Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by their primary care provider.
干预措施: Mailer (Behavioral)
Provider Mailer with a Pre-commitment Prompt
Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by their primary care provider.
干预措施: Pre-commitment Prompt (Behavioral)
Health System Mailer with a Pre-commitment Prompt
Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system
干预措施: Pre-commitment Prompt (Behavioral)
Provider Mailer without a Pre-commitment Prompt
Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the patient's provider.
干预措施: Mailer (Behavioral)
Health System Mailer with a Pre-commitment Prompt
Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system
干预措施: Mailer (Behavioral)
Provider Mailer with a Pre-commitment Prompt
Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by their primary care provider.
干预措施: Provider Request (Behavioral)
Health System Mailer without a Pre-commitment Prompt
Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system.
干预措施: Mailer (Behavioral)
Provider Mailer without a Pre-commitment Prompt
Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the patient's provider.
干预措施: Provider Request (Behavioral)
结局指标
主要结局
Proportion of patients with EHR-documented healthcare proxy
时间窗: From randomization through 30 days after the patient's scheduled index primary care visit date
Documentation in the electronic health record of a healthcare proxy
Proportion of patients with EHR-documented healthcare proxy
时间窗: Within 30 days of the patient's first scheduled primary care visit
Documentation in the electronic health record of a healthcare proxy
次要结局
- Proportion of patients with legal advance care planning documentation(Within 30 days of the patient's first scheduled primary care visit)
- Proportion of patients with legal advance care planning documentation within 90 days(Within 90 days of the patient's first scheduled primary care visit)
- Proportion of patients with legal advance care planning documentation(From randomization through 30 days after the patient's scheduled index primary care visit date)
- Proportion of patients that attended scheduled visit(On the date of the patient's scheduled index primary care visit)
- Proportion of patients with EHR-documented healthcare proxy through 90 days(From randomization through 90 days after the patient's scheduled index primary care visit date)
- Proportion of patients with legal advance care planning documentation through 90 days(From randomization through 90 days after the patient's scheduled index primary care visit date)
- Proportion of patients with primary care visit through 90 days(From randomization through 90 days after the patient's scheduled index primary care visit date)
- Proportion of patients with EHR-documented advance care planning conversation(Within 30 days of the patient's first scheduled primary care visit)
- Proportion of patients that attended scheduled visit(On the date of the patient's first scheduled primary care visit)
- Proportion of patients with EHR-documented healthcare proxy within 90 days(Within 90 days of the patient's first scheduled primary care visit)
- Proportion of patients with EHR-documented advance care planning conversation within 90 days(Within 90 days of the patient's first scheduled primary care visit)
- Proportion of patients with primary care visit within 90 days(Within 90 days of the patient's first scheduled primary care visit)
研究者
Mireille Jacobson
Professor
University of Southern California