The purpose of this study is to pilot test a telehealth Advance Care Planning (ACP) intervention among those with either mild cognitive impairment (MCI) or unrecognized dementia. Our goal is to pilot-test and evaluate a pragmatic Telehealth ACP intervention among patients with either the diagnosis of mild cognitive impairment (MCI) or unrecognized dementia.
Telehealth has the potential to overcome barriers related to timing and travel restraints and to provide patients and their caregivers with an opportunity to discuss their goals, values, and priorities for their healthcare within their home setting. Recent studies have demonstrated patients' willingness to use telehealth and have shown that it can play an integral role in dementia care management.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
152
Patients with either MCI or unrecognized dementia and their care partners (if available) will be approached to participate in a telehealth Advance Care Planning (ACP) visit with a member of the patient's primary care team via either telephone or video. Patients without willing or available care partners are still eligible to participate in the study.
Geriatric Medicine-Plaza 1 Davie
Bermuda Run, North Carolina, United States
Wake Forest Health Network Family Medicine Conover
Conover, North Carolina, United States
WFHN Family Medicine-Premier
High Point, North Carolina, United States
Wake Forest Health Network Internal Medicine
Jamestown, North Carolina, United States
WFBIK Geriatric Medicine-Kernersville
Kernersville, North Carolina, United States
WFHN Family Medicine-Thomasville
Thomasville, North Carolina, United States
Geriatric Medicine- Sticht Center
Winston-Salem, North Carolina, United States
Number of Patient/Care Partner Agreeing to Participate
Study will measure the amount of patient or patient-care partner dyads who agree to participate.
Time frame: Baseline to Month 9
Number of Participants With Telehealth Advance Care Planning (ACP) Completed
Study will measure the amount of patients or patient-care partner dyads who complete the ACP telehealth intervention.
Time frame: month 9
Number of Participants With One or More Advance Care Planning (ACP) Discussions
Study will measure the number of ACP discussions documented in the electronic health record.
Time frame: month 9
Number of Participants Who Used One or More Advance Care Planning (ACP) Billing Codes
Study will measure the usage of ACP billing codes (99497 and 99498).
Time frame: month 9
Quality of Advance Care Planning (ACP) Discussion Scores
Discussion quality will be operationalized using a scoring system derived from the ACP Wise documentation program. Score range of 0 (indicating no advance care planning questions answered) to 9 (indicating nine advance care planning questions answered). High-quality ACP discussions will be defined as addressing ≥4 out of 9 core components in the ACP discussion, with 1 point assigned if the following factors were addressed as part of the ACP discussion: Disease understanding, health-related goals, what matters most in their life, important milestones, health-related worries, named surrogate decision-maker, unacceptable states at the end-of-life (e.g. being in a coma, etc.), goals if their health was to worsen, and documentation of code status.
Time frame: month 9
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