Intervention to Promote Advance Care Planning for Older Adults in the Emergency Department

NCT03402763 | Completed

• 1 other identifier: 15-3371
• Study Type: interventional
• Target: 42
• Locations: 0 countries
• Sites: N/A

Brief Summary

There is an urgent need to increase advance care planning among older adults in order to ensure that patients receive care of the end of life that is consistent with their values and preferences. Emergency departments (EDs) provide an opportunity to reach a large proportion of older adults who have not yet completed advance care planning at a time when they are likely to recognize the need for such planning. The purpose of this pilot is to examine the potential of a video-supported intervention initiated during the emergency department visit to promote advance care planning.

Conditions

Emergency Medicine; Advance Care Planning

Keywords

Advance care planning; Older adults; Emergency department

Outcome Measures

Primary Outcomes (1)

• Documentation of end-of-life preferences in the electronic health record

  Since the ED visit, does the patient have any new preferences about CPR, intubation, or palliative care documented in their electronic health record?

  3 months

Secondary Outcomes (2)

• Conversation with Regular Provider

  3 months

• Conversation with Loved One

  3 months

Other Outcomes (2)

• CPR and Intubation Preferences

  3 months

• CPR Knowledge

  3 months

Study Arms (2)

Control Arm

NO INTERVENTION

Participants receive a short informational handout on the process and choices involved in advance care planning.

Intervention

EXPERIMENTAL

Participants are shown a 6-minute video that describe CPR, breathing tube placement, and mechanical breathing support in addition to the general process of advance care planning.

Behavioral: Educational Video; Behavioral: Primary Care Provider Email

Interventions

Educational Video BEHAVIORAL

The intervention is an educational video presented to patients in the ED with the intent to promote ACP among older adults.

Intervention

Primary Care Provider Email BEHAVIORAL

For intervention patients, an email will be sent to primary care providers explaining that the patient has seen a video about advance care planning, providing a synopsis of the video, and giving instructions about how to document end-of-life care preferences in the electronic health record.

Intervention

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• Ability to provide informed consent
• Ability to communicate in English
• Age 65-79 years with a serious medical illness: (1) Established diagnosis of metastatic cancer, advanced heart failure, chronic obstructive lung disease, end stage liver disease, end stage renal disease, (2) Unable to walk or requires human assistance with walking, (3) Two hospitalizations within the last 6 months
• Age 80 years or older

You may not qualify if:

• Critically ill (emergency severity index = 1)
• Cognitively impaired based on Six Item Screener \< 4 or lack the capacity to consent
• Currently enrolled in hospice or comfort care program
• No working phone number
• Non English speaker

Sponsors & Collaborators

• University of North Carolina, Chapel Hill: lead

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

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

Study Officials

• Timothy F Platts-Mills, MD

  University of North Carolina, Chapel Hill

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: All patients and researchers are aware if the patient receives a handout or watches the ACP video.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will (1) be given either a short informational handout on the process and choices involved in advanced care planning or (2) be shown a less 6 minute video describing CPR, breathing tube placement and mechanical breathing support in addition to the general process of advanced care planning.

Study Record Dates

• First Submitted: January 10, 2018
• First Posted: January 18, 2018
• Study Start: February 1, 2016
• Primary Completion: February 1, 2017
• Study Completion: February 1, 2017
• Last Updated: January 18, 2018

Record last verified: 2018-01

Data Sharing

• IPD Sharing: Will share
• Time Frame: Data will be uploaded within 1 year of study completion.