Motivational Interview Intervention to Help Patients Formulate Their Goals for Medical Care in the Emergency Department

NCT03208530 | Completed Results

• 1 other identifier: 2016P002637
• Study Type: interventional
• Target: 75
• Locations: 1 country
• Sites: 1

Brief Summary

Test the acceptability and feasibility of a brief motivational interview intervention to facilitate advance care planning (ACP) conversations for older adults with serious co-morbid illness being discharged from the emergency department (ED). The investigators will interview the participants to understand their perception of the intervention and collect patient-reported outcomes data after leaving the ED.

Conditions

Emergency Service, Hospital; Motivational Interviewing; Advance Care Planning

Outcome Measures

Primary Outcomes (1)

• Number of Patients Who Found the Intervention Acceptable and Provided Suggestions for Improvement

  The investigator will measure quantitatively and qualitatively whether patients found this intervention acceptable and provided suggestions for its improvement.

  Immediately following the intervention in the emergency department.

Secondary Outcomes (5)

• Acceptability of the Intervention by Administering Clinicians.

  Immediately following the intervention in the emergency department.

• Patient's Quality of Life

  At baseline (in-person) and 1 month after (over the phone) the intervention.

• Advance Care Planning Engagement Behavior

  At baseline (in-person) and 1 month after (over the phone) the intervention.

• Patient Empowerment

  At baseline (in-person) and 1 month after (over the phone) the intervention.

• Patient Distress

  Within 7 days after the intervention.

Study Arms (1)

Intervention Arm

EXPERIMENTAL

This is a single arm study with all enrolled patients receiving the same brief motivational interview intervention.

Behavioral: Brief motivational interview intervention

Interventions

Brief motivational interview intervention BEHAVIORAL

A brief (\<7minutes) interview by an emergency department clinician to empower patients to formulate and communicate their goals for medical care with patients' outpatient clinicians.

Intervention Arm

Eligibility Criteria

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

You may qualify if:

• ≥65 years of age
• English-speaking
• Capacity to consent
• AND ≥1 Serious illness (New York Heart Association stage 3 or 4 heart failure, oxygen-dependent chronic obstructive lung disease, chronic kidney disease on dialysis, and metastatic cancer.) OR determined by the emergency department provider that the patient has a high likelihood of death in the next 12 months ("I would not be surprised if this patient died in the next 12 months.").

You may not qualify if:

• Acute physical or emotional distress
• Determined by emergency department provider not to be appropriate
• Clearly documented goals for medical care already exists (e.g. medical order for life sustaining treatment - MOLST).
• Already enrolled in this study

Sponsors & Collaborators

• Brigham and Women's Hospital: lead

Study Sites (1)

Brigham and Women's Hospital

Boston, Massachusetts, 02115, United States

Location

Related Publications (1)

• Ouchi K, George N, Schuur JD, Aaronson EL, Lindvall C, Bernstein E, Sudore RL, Schonberg MA, Block SD, Tulsky JA. Goals-of-Care Conversations for Older Adults With Serious Illness in the Emergency Department: Challenges and Opportunities. Ann Emerg Med. 2019 Aug;74(2):276-284. doi: 10.1016/j.annemergmed.2019.01.003. Epub 2019 Feb 13.

  PMID: 30770207 DERIVED

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Limitations and Caveats

We did not collect some pre-specified outcomes because initial data suggested that they may not be clinically relevant.

Results Point of Contact

• Title: Kei Ouchi, MD, MPH
• Organization: Brigham and Women's Hospital

kei_ouchi@dfci.harvard.edu

(617) 732-5640

Study Officials

• Kei Ouchi, MD, MPH

  Brigham and Women's Hospital

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 3, 2017
• First Posted: July 5, 2017
• Study Start: August 1, 2017
• Primary Completion: May 31, 2019
• Study Completion: May 31, 2019
• Last Updated: January 13, 2022
• Results First Posted: February 25, 2021

Record last verified: 2022-01

Locations

US (1)