Advance Care Planning in Cognitive Disorders Clinic

University of Florida38 enrolled

Overview

Advance care planning among patients with cognitive disorders poses unique challenges to clinicians. To improve planning in patients with Alzheimer's disease and other dementias, the researchers suggest a routine, standardized approach to these conversations. The main outcome measure is the rate of entry of Advance Directive completion in the patient's Electronic Health Record (EHR). A control group of similar patients from another provider specializing in cognitive disorders will be used to tease out confounding variable effects.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Advance Care Planning

Interventions

Advance Care PlanningOTHER

The provider will guide advance care planning conversations with patients identified with mild or moderate dementia during their third office visit, approximately three months after the first visit.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 100 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients having mild cognitive impairment (MCI) or very mild to mild dementia (CDR 0.5-1). Exclusion Criteria: * Patients with moderate to severe dementia (CDR 2-3).

Locations (2)

Department of Neurology, College of Medicine, UF Health Medical Plaza

Gainesville, Florida, United States

UF Health Fixel Center for Neurological Diseases

Gainesville, Florida, United States

Outcomes

Primary Outcomes

Change in rate of advance directive completion during or following the visit

Time frame: Baseline; Month 6; Month 12; Month 18

Change in the rate of completed advance directives that are uploaded to the patient's electronic medical record

Time frame: Baseline; Month 6; Month 12; Month 18

Secondary Outcomes

Change in Hospital Anxiety and Depression Scale (HADS)

Scale consisting of 14 items (7 relating to anxiety; 7 to depression). Scores range from 0-21 (0-7 being normal; 08-10 being borderline abnormal; 11-21 being abnormal for anxiety and depression).

Time frame: Baseline; Month 2; Month 3

Change in Beck Hopelessness Scale (BHS)

Scale consisting of 20 true-false items arrayed within three factors: Feelings about the future, loss of motivation, and future expectations. Scores range from 0-20 (0-3 as are considered within the normal range, 4-8 identify mild hopelessness, scores from 9-14 identify moderate hopelessness, and scores greater than 14 identify severe hopelessness).

Time frame: Baseline; Month 2; Month 3

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.