Angelo E. Volandes|Gary H. Brandeis|Aretha Delight Davis|Michael K. Paasche?Orlow|Muriel R. Gillick|Yuchiao Chang|Elizabeth Walker-Corkery|Eileen Mann|Susan L. Mitchell
A Randomized Controlled Trial of a Goals-of-Care Video for Elderly Patients Admitted to Skilled Nursing Facilities
Harvard University|Massachusetts General Hospital|Boston University|Harvard University|Mount Auburn Hospital|Boston University|Harvard University|Harvard Pilgrim Health Care|Harvard University|Massachusetts General Hospital|Massachusetts General Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Hebrew SeniorLife
determine impact video preferences primary goal careconsecutive subjects 65 years age older n101 admitted two skilled nursing facilities snfs randomized verbal narrative control video intervention describing goalsofcare options options included lifeprolonging ie cardiopulmonary resuscitation limited ie hospitalization cardiopulmonary resuscitation comfort care ie symptom reliefprimary outcome patients preferences comfort versus options concordance preferences documentation medical record also examinedfiftyone subjects randomized verbal arm 50 video arm verbal arm preferences comfort n29 57 limited n4 8 lifeprolonging n17 33 uncertain n1 2 video arm preferences comfort n40 80 limited n4 8 lifeprolonging n6 12 randomization video associated greater likelihood opting comfort unadjusted rate ratio 14 95 confidence interval ci 1119 p002 among subjects verbal arm chose comfort 29 donotresuscitate dnr order statistic 018 95 ci002 037 33 subjects video arm choosing comfort dnr order statistic 006 95 ci009 022subjects admitted snfs viewed video likely exposed verbal narrative opt comfort concordance preference comfort dnr order low findings suggest need improve ascertainment patients preferencesclinicaltrialsgov identifier nct01233973