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A Mixed-Methods Comparison of Interventions to Increase Advance Care Planning.
Tietbohl, Caroline K; Ritger, Carly; Jordan, Sarah; Shanbhag, Prajakta; Sudore, Rebecca L; Lum, Hillary D.
Afiliación
  • Tietbohl CK; From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (CKT); Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO (CKT, CR); Division of Geriatric Medicine, De
  • Ritger C; From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (CKT); Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO (CKT, CR); Division of Geriatric Medicine, De
  • Jordan S; From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (CKT); Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO (CKT, CR); Division of Geriatric Medicine, De
  • Shanbhag P; From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (CKT); Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO (CKT, CR); Division of Geriatric Medicine, De
  • Sudore RL; From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (CKT); Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO (CKT, CR); Division of Geriatric Medicine, De
  • Lum HD; From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (CKT); Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO (CKT, CR); Division of Geriatric Medicine, De
J Am Board Fam Med ; 37(2): 215-227, 2024.
Article en En | MEDLINE | ID: mdl-38740474
ABSTRACT

PURPOSE:

Although interventions can increase advance care planning (ACP) engagement, it remains unclear which interventions to choose in primary care settings. This study compares a passive intervention (mailed materials) to an interactive intervention (group visits) on participant ACP engagement and experiences.

METHODS:

We used mixed methods to examine ACP engagement at baseline and six months following two ACP interventions. Eligible patients were randomized to receive mailed materials or participate in two ACP group visits. We administered the 4-item ACP Engagement survey (n = 110) and conducted interviews (n = 23). We compared mean scores and percent change in ACP engagement, analyzed interviews with directed content analysis to understand participants' ACP experiences, and integrated the findings based on mailed materials or group visits intervention.

RESULTS:

All participants demonstrated increased ACP engagement scores. At six months, group visit participants reported higher percent change in mean overall score compared with mailed materials participants (+8% vs +3%, P < .0001). Group visits participants reported that being prompted to think about end-of-life preferences, gaining knowledge about ACP, and understanding the value of completing ACP documentation influenced their ACP readiness. While both interventions encouraged patients to start considering and refining their end-of-life preferences, group visits made patients feel more knowledgeable about ACP, highlighted the importance of completing ACP documentation early, and sparked further ACP discussions with others.

CONCLUSIONS:

While primary care patients may benefit from mailed ACP materials, patients reported increased readiness after ACP group visits. Group visits emphasized the value of upstream preparation, ongoing conversations, and increased knowledge about ACP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Planificación Anticipada de Atención Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Board Fam Med Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Planificación Anticipada de Atención Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Board Fam Med Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos