Effect of an Advance Care Planning Intervention

N/ACompletedNCT04852055

Brown University2,364 enrolled

Overview

The intervention being studied is an advance care planning intervention. The trial has two arms: usual care and information arm.

Eligible patients whose assisted living centers are randomized to the information arm will receive a letter from their clinician with links to informational video. Eligible patients whose assisted living centers are randomized to the usual care arm have advance care planning discussions with a clinician at admission, annually, and sometimes with a hospitalization or other change in condition.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

2,364

Conditions

Dementia

Interventions

Advance Care Planning VideoBEHAVIORAL

Clinical assistants determine who is the correct person to receive the informational materials. If the patient is the correct recipient, clinicians will send the informational materials to the patient at the assisted living center. If the proxy is the correct recipient, the clinical assistant will determine whether or not the proxy is using the existing online portal. If the proxy is using the portal, the informational materials will be sent electronically. If the proxy does not access the portal, the informational materials will be sent to their residences.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Partnering assisted living center with at least 20 patients with a dementia diagnosis (based on International Classification of Diseases, version 10 codes) * Patients not on hospice * Patients who do not have comfort care or do-not-hospitalize orders at baseline Exclusion Criteria: * Partnering assisted living center with less than 20 patients with a dementia diagnosis (based on International Classification of Diseases, version 10 codes) * Patients on hospice * Patients with comfort care or do-not-hospitalize orders at baseline

Locations (1)

Bluestone Physician Services

Stillwater, Minnesota, United States

Outcomes

Primary Outcomes

Do-Not-Resuscitate

Percentage of residents with do-not-resuscitate orders documented in the electronic health record at end of follow-up, comparison between usual care and experimental arm

Time frame: 4 months

Secondary Outcomes

Do-Not-Hospitalize

Percentage of residents in each arm with do-not-hospitalize or comfort care orders documented in the electronic health record at end of follow-up, comparison between usual care and experimental arm

Time frame: 4 months

Advance Care Planning Billing

Percentage of residents in each arm with current procedural terminology billing code for advance care planning during follow-up based on Medicare claims data, comparison between usual care and experimental arm.

Time frame: 4 months

Hospitalization

Percentage of residents with any inpatient hospitalization during follow-up based on Medicare claims data (the MedPAR file), comparison between usual care and experimental arm.

Time frame: 4 months

Data from ClinicalTrials.gov

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