Refining an Advance Care Planning Group Visit Intervention - A Novel Intervention to Engage Older Adults in Advance Care Planning.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 110
- 试验地点
- 2
- 主要终点
- Presence of Medical Decision-maker Documentation in the EHR
研究概览
简要总结
The main goal of the ENACT (ENgaging in Advance Care planning Talks) Group Visit intervention is to integrate a patient-centered advance care planning process into primary care, ultimately helping patients to receive medical care that is aligned with their values. The ENACT Group Visit intervention involves two group discussions about advance care planning with 8-10 patients who meet for 2-hour sessions, one month apart, facilitated by a geriatrician and a social worker. This study will compare the ENACT Group Visit intervention to mailed advance care planning materials.
详细描述
This pilot feasibility randomized controlled study will determine the feasibility, acceptability and preliminary efficacy of the ENACT Group Visit intervention compared to a comparison arm.
The ENACT Group Visit intervention aims to engage patients in an interactive discussion of key ACP concepts and support patient-initiated ACP actions (i.e. choosing decision-maker(s), deciding on preferences during serious illness, discussing preferences with decision-makers and healthcare providers, and documenting advance directives). The group visits involve two 2-hour sessions, one month apart, facilitated by a geriatrician and a social worker. The ENACT Group Visit is based on an intervention manual that guides the structure, facilitator considerations, session format, and documentation and billing details. The discussions include sharing experiences related to ACP, considering values related to serious illness, choosing a surrogate decision-maker(s), flexibility in decision making, and having conversations with decision-makers and healthcare providers. The facilitators support an interactive discussion that promotes opportunities for patients to learn from others' experiences.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •50 or older
- •Receive primary care through UCHealth, Colorado, USA.
排除标准
- •Severe cognitive impairment, known diagnoses of dementia
- •Severe hearing loss or deafness
结局指标
主要结局
Presence of Medical Decision-maker Documentation in the EHR
时间窗: 0, 6 months
An MDPOA form is in electronic medical chart or an orally appointed decision maker
Presence of Advance Directive in the EHR
时间窗: 0 and 6 months
Presence of any advance directive document in the EHR (e.g., MDPOA, living will, Colorado MOST form)
次要结局
- Change in Readiness to Engage in ACP (ACP Engagement Score)(0, 6 months)
- Change in Readiness to Discuss Values and Care Preferences With Surrogate Decision Maker(0, 6 months)
- Change in Readiness to Chose a Surrogate Decision Maker(0, 6 months)
- Readiness to Sign Official Papers About Medical Care(0 and 6 months)
- Readiness to Talk to Patient's Physician About Future Medical Care(0 and 6 months)
- Change in Advance Directive in Medical Record(0, 3, 6, 12 months)