ACP Video Intervention for Patients With Life-Limiting Illness

Randomized Trial of a Home-Advance Care Planning Video Intervention for Patients With Life-Limiting Illness

The goal of this research is to increase patients' knowledge about advance care planning (ACP) discussions and hospice care for patients with serious illness receiving home-based care.

Study Overview

• Status: Recruiting
• Conditions: Health Care Utilization; End Stage Disease
• Intervention / Treatment: Behavioral: Home ACP Video

Detailed Description

ACP is a process that allows patients to communicate their wishes and preferences or medical care, when they are seriously ill, to their medical providers. The study investigators would like to assess whether a home-ACP video can improve patient-clinician communication about patients wishes for their medical care and lead to more patient-centered care.

This study is a randomized clinical trial of a Home-ACP intervention among 500 adult patients with serious illness receiving medical care at home with the Clover Health House Calls Program. Study participants will be assigned to one of two groups. In one group, participants will continue to receive usual care with their home-based care team. In the second group, participants will continue to receive their usual care with their home-based care team and also view an ACP video that helps them understand ACP and provides education about ACP and hospice care.

• Study Type: Interventional
• Enrollment (Estimated): 500
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Areej El-Jawahri, MD; Phone Number: 617-724-4000; Email: ael-jawahri@partners.org

Study Locations

• United States
  • New Jersey
    • Jersey City, New Jersey, United States, 07302
      • Recruiting
      • Clover Health
      • Contact: Kumar Dharmarajian, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Aged 21 or over
• Have a one-year prognosis or less as determined by Clover Health's validated algorithm
• Speak either English or one of the other 25 languages in which the video intervention is available

Exclusion Criteria:

• Visually impaired beyond 20/200 corrected
• Acute psychiatric illness or other comorbid condition that impairs cognitive ability to participate in advance care planning discussion as determined by the primary House Call Provider.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Usual Care; Usual care entails receiving usual medical care by the home-based care team.
Experimental: Video intervention; In addition to usual care, the intervention will entail having a visit by a trained study clinician to provide access to the ACP video. The study clinician will discuss the content of the video and answer any questions.	Behavioral: Home ACP Video; A video focused on Advance Care Planning and Hospice for patients with serious illness

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hospice utilization	Compare the use of hospice (yes vs. no) between the study groups	up to one year follow-up or death

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hospice length of stay	Compare hospice length-of-stay between the study groups	up to one year follow-up or death
Rates of documented resuscitation preferences in the Electronic Health Record	Compare documented resuscitation preferences in the Electronic Health Record between the two groups	up to one year follow-up or death
Rates of Advance Care Planning documentation in the Electronic Health Record	Compare advance care planning documentation in the Electronic Health Record between the two groups	up to one year follow-up or death
Patient knowledge about Advance Care Planning	Compare patient's knowledge about advance care planning using a 5-item knowledge questionnaire (range 0-5), higher score indicate more knowledge	Up to two days following the intervention visit
Patient reported confidence in care	Compare patient's reported confidence in their medical care using a single Likert response question between the two study groups. Score range from 0-4. Higher scores indicate higher confidence in care	up to two days following the intervention visit
Patient reported satisfaction with clinician communication	Compare patient satisfaction with their communication with their clinician using the CAHPS subscale. Score range 0-20. Higher score indicate better satisfaction with communication	up to two days following the intervention visit
Patient reported decisional satisfaction	Compare patient reported decisional satisfaction between the study groups using the Satisfaction with Decision Scale. Scale range from 6-30. Higher scores indicate higher satisfaction with decision	up to two days following the intervention visit
Patient reported decisional certainty	Compare patient reported decisional certainty between the two groups using the Decision Conflict Scale. Score ranges from 0 to 100. Higher scores indicate higher decisional conflict	up to two days following the intervention visit

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cost of care in the last year of life	Compare cost of care in the last year of life between the study groups	1 year

Collaborators and Investigators

• Sponsor: Massachusetts General Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2021
• Primary Completion (Actual): December 1, 2025
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: February 4, 2021
• First Submitted That Met QC Criteria: February 28, 2021
• First Posted (Actual): March 3, 2021

Study Record Updates

• Last Update Posted (Actual): January 20, 2026
• Last Update Submitted That Met QC Criteria: January 15, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Treatment Adherence and Compliance; Health Behavior; Patient Acceptance of Health Care
• Other Study ID Numbers: 2020P001277

Drug and device information, study documents

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