Multiprofessional Advance Care Planning and Shared Decision Making for End of Life Care (MAPS)

Multiprofessional Advance Care Planning and Shared Decision-making for End of Life Care MAPS Trial

Multiprofessional Advance Care Planning and shared decision making for end of live care for terminal patients and their relatives.

The aim of this study is to develop, implement and test a complex intervention for improving patients' preparation for and participation in end of life decisions. In cooperation with local, national and international partners, the investigators will focus on strategies to enhance advance care planning and shared decision making on end of life issues, and documentation and transferability of end of life decisions across health care settings in coordinated approach involving patients, their families and care givers (in and out of hospital).

Study Overview

• Status: Completed
• Conditions: Palliative Patients; Surrogate Decision Maker
• Intervention / Treatment: Other: Control Group; Other: Advance Care Planning ACP

• Study Type: Interventional
• Enrollment (Actual): 115
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Switzerland
  • ZH
    • Zurich, ZH, Switzerland, 8091
      • University Hospital Zurich, Clinical Ethics

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion criteria: -patients in which the treating physician on the ward would not be surprised if the patient died during the next year (surprise question of Weissman et al 2011)

• male and female patients above 18 years of age
• signed informed consent after being informed
• patients able to appoint a surrogate decision maker (SM) and/or responsible physician to be contacted after discharge

Exclusion criteria: -patients not capable of speaking german

• patients having no responsible physician to be contacted after discharge and no relative/future surrogate decision maker (SM)
• inhouse patients being discharged within the next 2 days or ambulatory patients not regularly coming to the wards (at least every two month)
• patients assessed by their physician to be in obvious denial of their situation (illness/prognosis)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Group; A routine care discharge planning with the social service	Other: Control Group; A routine care discharge planning with the social service
Experimental: Advance Care Planning ACP; Patient get a decision aid video and library and up to 3 consultations with qualified Advance Care Planning Facilitators. --------------------------------------------------------------------------------	Other: Advance Care Planning ACP; Patient of the intervention group get a decision aid video and library and up to 3 consultations with qualified Advance Care Planning Facilitators.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
end of life wish on resuscitation known (if alive) or fulfilled(if dead) after 6 month by responsible physician and/or surrogate decision maker (SM)	during 2 weeks six months after discharge

Secondary Outcome Measures

Outcome Measure	Time Frame
end of live decisions on last place of care, antibiotics for pneumonia, feeding tube, intravenous fluids, dialysis, intubation and sedation,	during 2 weeks six months after discharge
decisional conflict scale ("DCS"), O Connor et al 1995	at discharge and during 2 Weeks six months after discharge
Satisfaction with information and care, (see Detering et al 2010)	at discharge
Hospital Anxiety and Depression scale ("HADS")	discharge and during 2 weeks six months after discharge
Having an Advance directive	at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge
Having an appointed surrogate decision maker	at discharge, during 2 weeks three month after discharge and during 2 weeks six month after discharge
Any hospital stay	during 2 weeks three months after discharge and during 2 weeks six months after discharge
Decisions regarding end of life issues already having been made/taken place	during 2 weeks six months after discharge
open question on important medical decisions being made	during 2 weeks three months after discharge
Treatment against patients wishes	during 2 weeks three months after discharge and during 2 weeks six months after discharge, or 3 month after death
Distress of Patients or relatives because of content of the consultation	at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge

Collaborators and Investigators

• Sponsor: University of Zurich
• Investigators: Principal Investigator: Tanja Krones, MD, University Hospital Zurich, Clinical Ethics

Study record dates

Study Major Dates

• Study Start: July 1, 2013
• Primary Completion (Actual): April 1, 2015
• Study Completion (Actual): August 1, 2015

Study Registration Dates

• First Submitted: November 26, 2012
• First Submitted That Met QC Criteria: July 30, 2013
• First Posted (Estimate): August 2, 2013

Study Record Updates

• Last Update Posted (Estimate): June 6, 2016
• Last Update Submitted That Met QC Criteria: June 3, 2016
• Last Verified: June 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Death
• Other Study ID Numbers: MAPS Trial