Comparison of a Web-based Advance Directive to a Standard Advance Directive

NCT03676426 | Completed

• 1 other identifier: 829211
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

This study will compare a web-based advance directive to a standard advance directive.

Conditions

GI Cancer; Thoracic Cancer

Outcome Measures

Primary Outcomes (1)

• New documentation of advance care planning in the EHR

  any new advance directive or advance care planning note, excluding an advance directive that either 1) contains only information on the patient's preferred surrogate decision-makers, or 2) is blank except for personal identifying information.

  8 weeks

Secondary Outcomes (6)

• Change in satisfaction with end-of-life plans

  Initial completed at enrollment, survey sent again at 15 days

• Acceptability

  Survey sent at 15 days (reminders at 2 week intervals x 2, then phone call)

• Self reporting sharing with surrogate

  Survey sent at 15 days (reminders 4, 6)Survey sent at 15 days (reminders at 2 week intervals x 2, then phone call)

• Self reporting completion

  Survey sent at 15 days (reminders at 2 week intervals x 2, then phone call)

• Qualitative feedback

  Survey sent at 15 days (reminders at 2 week intervals x 2, then phone call)

Study Arms (2)

Web-based AD

EXPERIMENTAL

Patients will be encouraged to use the web platform for advance care planning/advance directive to document their care preferences..

Other: Web platform for advance care planning/advance directive

Paper AD

ACTIVE COMPARATOR

Patients will be given the standard advance directive and encouraged to complete on their own.

Other: Standard advance directive

Interventions

Web platform for advance care planning/advance directive OTHER

Ourcarewishes (OCW) is a web-based platform to document advance care planning based at Penn. OCW contains more detailed content on preferences and values than a standard advance directive and allows electronic sharing with loved ones and transmission to the Penn EHR.

Also known as: ourcarewishes.org

Web-based AD

Standard advance directive OTHER

Patients receive a paper copy of an advance directive used by social workers at Penn Medicine and are encouraged to complete on their own.

Paper AD

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Pancreatic cancer, any stage except stage 0 (C25),
• NSCLC, stage IIIA or higher (C34),
• SCLC, any stage (C34),
• Colon cancer, stage IIIB or greater (C18),
• Rectal cancer, stage IIB or greater (C21),
• Esophageal cancer (adeno or squamous), any stage (C15),
• Stomach cancer, stage IIB or greater (C16),
• Gallbladder cancer, stage I or greater (C23),
• Cholangiocarcinoma, any stage (C22.1),
• HCC, any stage (no plan for transplant) (C22.0),
• Malignant carcinoid of GI tract, stage IV (C7A.019).

You may not qualify if:

• Does not have an active patient portal (MyPennMedicine) account,
• Does not use email at least once per month,
• Has already completed a living will,
• Does not speak fluent English,
• Unwilling to be contacted by email,
• Determined to be too ill or inappropriate for participation by patient's oncologist.

Sponsors & Collaborators

• University of Pennsylvania: lead

Study Sites (1)

Ruth & Raymond Perelman Center for Advanced Medicine

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (2)

• Halpern SD, Loewenstein G, Volpp KG, Cooney E, Vranas K, Quill CM, McKenzie MS, Harhay MO, Gabler NB, Silva T, Arnold R, Angus DC, Bryce C. Default options in advance directives influence how patients set goals for end-of-life care. Health Aff (Millwood). 2013 Feb;32(2):408-17. doi: 10.1377/hlthaff.2012.0895.

  PMID: 23381535 BACKGROUND

• Sudore RL, Landefeld CS, Barnes DE, Lindquist K, Williams BA, Brody R, Schillinger D. An advance directive redesigned to meet the literacy level of most adults: a randomized trial. Patient Educ Couns. 2007 Dec;69(1-3):165-95. doi: 10.1016/j.pec.2007.08.015. Epub 2007 Oct 17.

  PMID: 17942272 BACKGROUND

MeSH Terms

Conditions

Gastrointestinal Neoplasms

Interventions

Advance Care Planning; Advance Directives

Condition Hierarchy (Ancestors)

Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases

Intervention Hierarchy (Ancestors)

Patient Care Planning; Comprehensive Health Care; Patient Care Management; Health Services Administration; Jurisprudence; Social Control, Formal; Health Care Economics and Organizations

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Patients will be blinded to the comparison being made, but not to the intervention in their arm.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 7, 2018
• First Posted: September 18, 2018
• Study Start: October 15, 2018
• Primary Completion: October 20, 2019
• Study Completion: February 20, 2020
• Last Updated: May 7, 2020

Record last verified: 2020-05

Locations

US (1)