Chronic Disease, Frail Elderly Syndrome
Conditions
Brief summary
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.
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.
Interventions
BEHAVIORALAdvance 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
Sponsors
Canadian Frailty Network
McMaster University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
Single group before-after
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Advance care planning engagement | 12 weeks | Survey measuring domains of engagement in advance care planning |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Advance care planning engagement-substitute decision maker | 12 weeks | survey measuring substitute decision maker domains of engagement in advance care planning |
| Patient experience | 12 weeks | survey of patient experience with intervention |
| Patient perceived impact on health care | 6-9 months | qualitative interviews of patients asking perceived impact of intervention on later health care use |
Other
| Measure | Time frame | Description |
|---|---|---|
| Clinician experience of intervention | 6 months | survey of clinician experience using conversation tools |
| Clinician confidence having advance care planning conversations | 6 months | survey of clinician confidence, satisfaction |
Countries
Canada
Outcome results
None listed