Consumer Engagement to Increase Advance Care Planning

NCT02208947 | Terminated Phase 3

• 1 other identifier: PRO13120230
• Study Type: interventional
• Target: 77
• Locations: 1 country
• Sites: 1

Brief Summary

The specific aims of the project are: 1) to test the effectiveness of consumer-directed financial incentives paired with provider-directed financial incentives, compared to provider-directed financial incentives alone, for increasing advance care planning (ACP) among Medicaid beneficiaries; and 2) to assess perceptions regarding the appropriateness of consumer-directed financial incentives for ACP among study participants. The investigators hypothesize that consumer-directed financial incentives will result in a 15-percentage point absolute increase in the proportion of subjects completing ACP. The investigators do not advance hypotheses about the qualitative component.

Conditions

Advance Care Planning

Keywords

advance care planning; decision making; patient engagement; patient education; financial incentives; behavioral economics

Outcome Measures

Primary Outcomes (1)

• Advance care planning conversation with provider

  The primary outcome is the patient discussing their ACP with their provider within 2 months of having received the study advance care planning information packet, measured by the provider submitting an attestation form to Partnership HealthPlan of California to receive their ACP quality incentive payment.

  2 months (+/- 1 month)

Secondary Outcomes (1)

• Use of the PREPARE website

  2 months (+/- 1 month)

Study Arms (2)

PREPARE

ACTIVE COMPARATOR

Partnership HealthPlan of California (PHC) pays primary care physicians (PCPs) to discuss and document ACP with Medi-Cal beneficiaries aged 65 and older and those younger than 65 with a life-limiting illness (usual care). The control condition, or "enhanced usual care," adds a packet of educational information about ACP and access to the PREPARE website and verbal encouragement by their PCP delivered during a routine clinic visit to usual care.

Behavioral: PREPARE

PREPARE + consumer financial incentive

EXPERIMENTAL

The experimental condition adds a consumer-directed financial incentive to enhanced usual care (provider-directed financial incentive and educational packet with information about the PREPARE website). Specifically, subjects will receive an immediate financial reward upon completing self-directed ACP (e.g., PREPARE steps 1-4) and a small probability of a large reward for discussing the plans with their physician (e.g., PREPARE step 5, documented by the PHC ACP attestation form).

Behavioral: Consumer financial incentive; Behavioral: PREPARE

Interventions

Consumer financial incentive BEHAVIORAL

Immediate financial reward upon completing self-directed ACP (e.g., completing the web-based educational modules on PREPARE steps 1-4) and a small probability of a large reward for discussing the plans with their physician (e.g., PREPARE step 5, documented by the PHC ACP attestation form).

PREPARE + consumer financial incentive

PREPARE BEHAVIORAL

PREPARE for your care is 5-step on-line ACP process developed specifically for low-literacy Medi-Cal populations. PREPARE can be navigated as interactive, self-directed modules or "played" like a movie, at a time or a place of the subject's own choosing (e.g., home, work, public library).

PREPARE; PREPARE + consumer financial incentive

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Partnership HealthPlan of California Medicaid and/or Medicare provider

You may not qualify if:

• Prohibition by clinic director
• Partnership HealthPlan of California Medicaid and/or Medicare enrollee;
• Age 65+ or \< 65 with a life-limiting illness (including advanced cardiac disease \[end-stage congestive heart failure, severe coronary artery disease, cardiomyopathy (LVEF \<25%)\], advanced chronic obstructive pulmonary disease, amputation due to vascular disease, cancer \[metastatic/recurrent\], dementia, diabetes mellitus with creatinine clearance under 50, or an amputation, end stage renal disease, generalized debility and decreased functioning, long term resident of skilled nursing facility, stroke \[w/at least 50% decreased function\]);
• Internet access (computer, tablet, phone)
• Completion of a Partnership HelathPlan of California advance care planning attestation form within the last 12 months;
• Inability to read English

Sponsors & Collaborators

• University of Pittsburgh: lead
• Donaghue Medical Research Foundation: collaborator
• Robert Wood Johnson Foundation: collaborator

Study Sites (1)

Partnership HealthPlan-contracting provider groups in Northern California

Fairfield, California, 94534, United States

Location

MeSH Terms

Conditions

Patient Participation

Condition Hierarchy (Ancestors)

Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Amber E Barnato, MD MPH MS

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: June 19, 2014
• First Posted: August 5, 2014
• Study Start: April 1, 2014
• Primary Completion: November 1, 2014
• Study Completion: February 1, 2015
• Last Updated: June 15, 2017

Record last verified: 2017-06

Locations

US (1)