Effect of the PREPARE Website vs an Easy-to-Read Advance Directive on Advance Care Planning Documentation and Engagement Among Veterans: A Randomized Clinical Trial

JAMA Internal Medicine
Rebecca L SudoreDeborah E Barnes

Abstract

Documentation rates of patients' medical wishes are often low. It is unknown whether easy-to-use, patient-facing advance care planning (ACP) interventions can overcome barriers to planning in busy primary care settings. To compare the efficacy of an interactive, patient-centered ACP website (PREPARE) with an easy-to-read advance directive (AD) to increase planning documentation. This was a comparative effectiveness randomized clinical trial from April 2013 to July 2016 conducted at multiple primary care clinics at the San Francisco VA Medical Center. Inclusion criteria were age of a least 60 years; at least 2 chronic and/or serious conditions; and 2 or more primary care visits; and 2 or more additional clinic, hospital, or emergency room visits in the last year. Participants were randomized to review PREPARE plus an easy-to-read AD or the AD alone. There were no clinician and/or system-level interventions or education. Research staff were blinded for all follow-up measurements. The primary outcome was new ACP documentation (ie, legal forms and/or discussions) at 9 months. Secondary outcomes included patient-reported ACP engagement at 1 week, 3 months, and 6 months using validated surveys of behavior change process measures (ie,...Continue Reading

Citations

Nov 23, 2016·Journal of the American Geriatrics Society·Timothy W FarrellUNKNOWN Ethics, Clinical Practice and Models of Care, and Public Policy Committees of the American Geriatrics Society
Feb 13, 2018·Journal of Palliative Medicine·Kara BischoffMichael W Rabow
Sep 13, 2018·Journal of the American Geriatrics Society·Kaitlin WillhamEric Widera
Oct 6, 2018·Journal of the American Geriatrics Society·Anna KataVictoria L Tang
Oct 10, 2018·Current Opinion in Supportive and Palliative Care·Claire K Ankuda, Diane E Meier
Nov 28, 2018·Journal of Palliative Medicine·Barbara L RoseJulie Childers
Aug 22, 2018·Journal of Palliative Medicine·J Nicholas Dionne-OdomMarie A Bakitas
Aug 22, 2018·Journal of Palliative Medicine·Daniel DavidRebecca L Sudore
Jan 31, 2019·The American Journal of Hospice & Palliative Care·Joshua A RolnickScott D Halpern
Jan 18, 2019·Journal of Social Work in End-of-life & Palliative Care·Yoshihisa HirakawaAtsuko Aoyama
Mar 26, 2019·Journal of the American Geriatrics Society·Krista L HarrisonKristine Yaffe
Apr 2, 2019·Journal of Palliative Medicine·Harriet L MatherLaura P Gelfman
Jul 5, 2019·Journal of the American Geriatrics Society·Andrea PaivaTerri R Fried
Nov 7, 2019·The Cochrane Database of Systematic Reviews·Joanne E ButterworthJohn Campbell
Nov 11, 2019·Journal of General Internal Medicine·Ariel R GreenCynthia M Boyd
Mar 12, 2020·Journal of the American Geriatrics Society·Jennifer FreytagRebecca L Sudore
Mar 18, 2020·Journal of Medical Internet Research·Doris van der SmissenIda J Korfage
Mar 18, 2020·Journal of Palliative Medicine·Lauren M KaplanMargot Kushel
Apr 29, 2020·Neurology·Nicole R Gonzales, Alexandra S Reynolds
Oct 28, 2019·Journal of General Internal Medicine·Leslie W SuenRebecca L Sudore
Jul 11, 2020·The American Journal of Hospice & Palliative Care·Joshua A RolnickScott D Halpern
Jul 30, 2020·Journal of the American Geriatrics Society·Hillary D LumRebecca L Sudore
Sep 18, 2020·The American Journal of Hospice & Palliative Care·Meghan McDarbyElissa Kozlov
Aug 29, 2017·Journal of Oncology Practice·Keith M Swetz
Sep 8, 2020·Journal of the American Geriatrics Society·Ryan D McMahanRebecca L Sudore
Jan 31, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·John HeymachHarold Burstein
Apr 1, 2020·Gerontology & Geriatrics Education·Maria T CarneyRenee Pekmezaris
May 27, 2020·BMC Family Practice·Carrie BernardMichelle Howard
Jun 21, 2020·International Journal of Environmental Research and Public Health·Hsin-Lung ChanYvonne Hsiung
Jun 6, 2018·JAMA Internal Medicine·Nathan E Goldstein, Harriet Mather

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.