Effectiveness of initiating advance care planning among older outpatients through intervention by physicians trained in a model discussion video: A randomized controlled trial
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View abstract on PubMed
Summary
This summary is machine-generated.A physician-led intervention using a model video significantly increased advance care planning (ACP) discussions and readiness in older outpatients. This approach enhanced patient engagement without increasing anxiety.
Area Of Science
- Geriatric Medicine
- Public Health
- Medical Education
Background
- Advance care planning (ACP) is crucial for older adults to align medical care with their values.
- Implementing effective ACP interventions in primary care settings remains a challenge.
Purpose Of The Study
- To assess the impact of a physician-led intervention using a model discussion video on introducing advance care planning (ACP) to older outpatients.
- To evaluate the intervention's effect on ACP discussion occurrence, engagement, and anxiety levels.
Main Methods
- A prospective interventional study involving Japanese general practice outpatients aged 65 years and older.
- The intervention group received an ACP leaflet and standardized explanations using a model video, while the control group received only the leaflet.
- Outcomes included ACP discussion, ACP engagement (4-item survey, advance directives, surrogate decision-maker), and anxiety (GAD-7).
Main Results
- The intervention group showed significantly higher ACP discussion rates (92.0%) compared to the control group (26.1%).
- Intervention participants demonstrated greater readiness for ACP, including higher scores for advance directives acquisition and surrogate decision-maker identification.
- No significant increase in anxiety was observed in the intervention group.
Conclusions
- Physician-led ACP introduction, supported by a model discussion video, effectively enhances ACP readiness and stimulates discussions among older outpatients in Japanese general practice.
- This intervention model shows promise for training physicians to facilitate ACP in primary care settings.
- The intervention successfully promoted advance care planning without adversely affecting patient anxiety levels.
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