Empowering Older Adults to Discuss Advance Care Planning During Clinical Visits: The PREPARE Randomized Trial.

Journal of the American Geriatrics Society
Jennifer FreytagRebecca L Sudore

Abstract

A patient-directed, online program (PREPARE for Your Care [PREPARE]; prepareforyourcare.org) has been shown to increase advance care planning (ACP) documentation. However, the mechanisms underlying PREPARE are unknown. Our objectives were to compare the efficacy of PREPARE plus an easy-to-read advance directive (AD) vs an AD alone to increase active patient participation in ACP discussions during clinic visits and to examine effects of active patient participation on ACP documentation. Audio recordings of postintervention primary care visits from two randomized trials (2013-2016). Seven primary care clinics at a veterans affair and safety-net hospital in San Francisco, CA. English- and Spanish-speaking adults, aged 55 years and older, with two or more chronic/serious conditions. PREPARE plus an easy-to-read AD or an AD alone. The primary outcome was the number of active patient participation utterances about ACP (eg, asking questions, stating preferences) measured by the validated Active Patient Participation Coding Scheme. We examined differences in utterances by study arm using mixed effects negative binomial models and utterances as a mediator of PREPARE's effect on documentation using adjusted logistic regression. Models we...Continue Reading

References

May 1, 1992·Social Science & Medicine·R L Street
Apr 1, 1997·Image--the Journal of Nursing Scholarship·B B Ott, T L Hardie
Jul 22, 1999·Social Science & Medicine·E KrupatJ B McKinlay
May 16, 2001·Social Science & Medicine·M GattellariM H Tattersall
May 24, 2001·Health Communication·R L Street, B Millay
May 25, 2002·Journal of the American Geriatrics Society·Eric L KrakauerKen Fox
Aug 13, 2003·Journal of General Internal Medicine·Richard L StreetPaul Haidet
Mar 11, 2004·Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing·Linda A BriggsElaine R Colvin
Mar 30, 2005·Archives of Internal Medicine·Robert A PearlmanWilliam G Cole
Feb 17, 2007·Journal of the American Geriatrics Society·Sharda D RamsaroopRonald D Adelman
Oct 19, 2007·Patient Education and Counseling·Rebecca L SudoreDean Schillinger
Jan 28, 2009·Journal of the American Geriatrics Society·Adam D SchickedanzRebecca L Sudore
Mar 25, 2010·BMJ : British Medical Journal·Karen M DeteringWilliam Silvester
Aug 18, 2010·Annals of Internal Medicine·Rebecca L Sudore, Terri R Fried
Apr 3, 2013·JAMA Internal Medicine·Daren K HeylandUNKNOWN Canadian Researchers at the End of Life Network (CARENET)
Aug 27, 2013·Journal of Pain and Symptom Management·Rebecca L SudoreDeborah E Barnes
Oct 23, 2013·BMJ : British Medical Journal·Anjali MullickLibby Sallnow
Jul 16, 2014·Patient Education and Counseling·Kim BrandesAdam Walczak
Jul 30, 2014·Annals of Internal Medicine·Mary ButlerRobert L Kane
May 20, 2016·Journal of General Internal Medicine·Angelo E VolandesRae Seitz
Nov 2, 2016·JAMA Internal Medicine·Krista L HarrisonAlexander K Smith
Jan 8, 2017·Journal of Pain and Symptom Management·Rebecca L SudoreDaren K Heyland
Feb 28, 2017·Patient Education and Counseling·Thomas A D'AgostinoPatricia A Parker
Jun 26, 2018·Journal of Pain and Symptom Management·Hillary D LumRebecca L Sudore

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Citations

Mar 25, 2021·Journal of the American Geriatrics Society·Susan E HickmanBernard J Hammes
Jun 4, 2021·Journal of the American Geriatrics Society·Charlotte ScheerensRebecca L Sudore
Jul 17, 2021·Journal of Pain and Symptom Management·Charlotta LindvallThe Acp-Peace Investigators James A Tulsky
Nov 11, 2021·Journal of the American Geriatrics Society·Sarah NouriRebecca L Sudore

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