Effect of an Advance Care Planning Intervention on Documentation of Advance Directives and Goals of Care in Assisted Living Centers
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 2,364
- 试验地点
- 1
- 主要终点
- Do-Not-Resuscitate
研究概览
简要总结
The intervention being studied is an advance care planning intervention. The trial has two arms: usual care and information arm.
详细描述
Eligible patients whose assisted living centers are randomized to the information arm will receive a letter from their clinician with links to informational video. Eligible patients whose assisted living centers are randomized to the usual care arm have advance care planning discussions with a clinician at admission, annually, and sometimes with a hospitalization or other change in condition.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Partnering assisted living center with at least 20 patients with a dementia diagnosis (based on International Classification of Diseases, version 10 codes)
- •Patients not on hospice
- •Patients who do not have comfort care or do-not-hospitalize orders at baseline
排除标准
- •Partnering assisted living center with less than 20 patients with a dementia diagnosis (based on International Classification of Diseases, version 10 codes)
- •Patients on hospice
- •Patients with comfort care or do-not-hospitalize orders at baseline
研究组 & 干预措施
Usual Care
Patients and proxies in assisted living centers randomized to the usual care arm have advance care planning discussions with a clinician at admission, annually, and sometimes with a hospitalization or other change in condition. There is no standardized decision- or conversation-support tools used to have these discussions.
Information
Patients and proxies in assisted living centers randomized to the information arm will receive a letter from their clinician with a link to an educational video describing the goals of care and how specific treatment decisions align with these goals. Patients and proxies will also continue to receive usual care advance care planning conversations.
干预措施: Advance Care Planning Video (Behavioral)
结局指标
主要结局
Do-Not-Resuscitate
时间窗: 4 months
Percentage of residents with do-not-resuscitate orders documented in the electronic health record at end of follow-up, comparison between usual care and experimental arm
次要结局
- Do-Not-Hospitalize(4 months)
- Advance Care Planning Billing(4 months)
- Hospitalization(4 months)
- Do-Not-Hospitalize(4 months)
- Advance Care Planning Billing(4 months)
- Hospitalization(4 months)
研究者
Vincent Mor
Florence Pirce Grant University Professor, Professor of Health
Brown University