Advance Care Planning
Conditions
Keywords
Alzheimer's disease, Dementia
Brief summary
Advance care planning among patients with cognitive disorders poses unique challenges to clinicians. To improve planning in patients with Alzheimer's disease and other dementias, the researchers suggest a routine, standardized approach to these conversations. The main outcome measure is the rate of entry of Advance Directive completion in the patient's Electronic Health Record (EHR). A control group of similar patients from another provider specializing in cognitive disorders will be used to tease out confounding variable effects.
Interventions
OTHERAdvance Care Planning
The provider will guide advance care planning conversations with patients identified with mild or moderate dementia during their third office visit, approximately three months after the first visit.
Sponsors
Florida Department of Health
University of Florida
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Patients having mild cognitive impairment (MCI) or very mild to mild dementia (CDR 0.5-1).
Exclusion criteria
* Patients with moderate to severe dementia (CDR 2-3).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in rate of advance directive completion during or following the visit | Baseline; Month 6; Month 12; Month 18 |
| Change in the rate of completed advance directives that are uploaded to the patient's electronic medical record | Baseline; Month 6; Month 12; Month 18 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Hospital Anxiety and Depression Scale (HADS) | Baseline; Month 2; Month 3 | Scale consisting of 14 items (7 relating to anxiety; 7 to depression). Scores range from 0-21 (0-7 being normal; 08-10 being borderline abnormal; 11-21 being abnormal for anxiety and depression). |
| Change in Beck Hopelessness Scale (BHS) | Baseline; Month 2; Month 3 | Scale consisting of 20 true-false items arrayed within three factors: Feelings about the future, loss of motivation, and future expectations. Scores range from 0-20 (0-3 as are considered within the normal range, 4-8 identify mild hopelessness, scores from 9-14 identify moderate hopelessness, and scores greater than 14 identify severe hopelessness). |
Countries
United States
Outcome results
None listed