Implementing Advance Care Planning Conversation Tools in Family Practice

This study evaluates the use of advance care planning conversation tools with patients attending their family doctor's office. Patients complete tools about their values and wishes, and a health care provider uses a structured discussion tool to talk about the patient's health condition and future wishes. The patient's family member/substitute decision-maker is encouraged to attend and be part of the discussions.

Study Overview

• Status: Completed
• Conditions: Chronic Disease; Frail Elderly Syndrome
• Intervention / Treatment: Behavioral: Advance care planning tools

Detailed Description

Structured tools are helpful for advance care planning. Tools have been developed to help with advance care planning because it is a process which has multiple steps and people involved. This study will help health care teams in primary care learn to use the tools with frail or older seriously ill patients and will evaluate the perceptions of patients, family members and health care providers, as well as the impact of having the discussions on subsequent health care interactions the patient has.

Patients complete tools about their values and wishes, and a health care provider uses a structured discussion tool to talk about the patient's health condition and future wishes. The patient's family member/substitute decision-maker is encouraged to attend and be part of the discussions.

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Calgary, Alberta, Canada, T1Y 5S3
      • Sunridge Family Medicine Teaching Centre
  • British Columbia
    • Langley, British Columbia, Canada
      • Safa Medical Clinic
    • Vancouver, British Columbia, Canada, V3L 3C2
      • New Westminster Family Practice
    • Vancouver, British Columbia, Canada
      • Vancouver General Hospital Gordon and Leslie Diamond Health Care Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• age 60 or older
• chronic condition that may reduce life expectancy as per physician's clinical judgement
• able to communicate verbally in English and read English

Exclusion Criteria:

• unable to communicate verbally in English
• unable to read English
• cognitively unable to give informed consent (e.g. memory problems) as judged by referring physician or research assistant

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Advance care planning tools; Advance care planning education and structured conversation using tools	Behavioral: Advance care planning tools; Structured conversations between patients/substitute decision-maker and clinician based on education about advance care planning using locally relevant booklet/website, values clarification tool for patient engagement, clinician use of the Serious Illness Conversation Guide

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Advance care planning engagement	Survey measuring domains of engagement in advance care planning	12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Advance care planning engagement-substitute decision maker	survey measuring substitute decision maker domains of engagement in advance care planning	12 weeks
Patient experience	survey of patient experience with intervention	12 weeks
Patient perceived impact on health care	qualitative interviews of patients asking perceived impact of intervention on later health care use	6-9 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinician experience of intervention	survey of clinician experience using conversation tools	6 months
Clinician confidence having advance care planning conversations	survey of clinician confidence, satisfaction	6 months

Collaborators and Investigators

• Sponsor: McMaster University
• Collaborators: Canadian Frailty Network
• Investigators: Principal Investigator: Michelle Howard, PhD, McMaster University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2018
• Primary Completion (Actual): September 30, 2020
• Study Completion (Actual): October 30, 2020

Study Registration Dates

• First Submitted: April 16, 2018
• First Submitted That Met QC Criteria: April 16, 2018
• First Posted (Actual): April 25, 2018

Study Record Updates

• Last Update Posted (Actual): January 19, 2022
• Last Update Submitted That Met QC Criteria: January 17, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Chronic Disease
• Other Study ID Numbers: TG2015-03D

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No