Rebecca L. Sudore|Gem M. Le|Ryan Mcmahan|Mariko Feuz|Mary Katen|Deborah E. Barnes
The advance care planning PREPARE study among older Veterans with serious and chronic illness: study protocol for a randomized controlled trial
University of California, San Francisco|University of California, San Francisco|San Francisco VA Medical Center|San Francisco VA Medical Center|San Francisco VA Medical Center|University of California, San Francisco
advance care planning acp process whereby patients prepare medical decisionmaking traditional objective acp focused completion advance directives developed new paradigm acp focused preparing patients loved ones communication informed medical decisionmaking operationalize new paradigm acp created interactive patientcentered website called prepare wwwprepareforyourcareorg designed diverse older adultsthis randomized controlled trial blinded outcome assessment designed determine efficacy prepare engage older veterans acp process veterans 60 years age two medical conditions seen primary care physician two times last year randomized one two study arms prepare study arm reviews prepare website easytoread advance directive control arm reviews advance directive primary outcome documentation advance directive acp discussions clinically important outcomes using validated surveys include acp behavior change process measures knowledge contemplation selfefficacy readiness full range acp action measures identifying surrogate identifying values goals choosing leeway flexibility surrogate communicating clinicians surrogates documenting ones wishes also assess satisfaction decisionmaking veteran activation within primary care visits direct audio recording examine outcomes 1 week 3 months 6 months two study arms use mixed effects linear poisson negative binomial regression mixed effects logistic regressionthis study determine whether prepare increases advance directive completion rates engagement acp process prepare efficacious could prove easy effective intervention help older adults engage acp process within outside medical environment prepare may also help older adults communicate medical wishes goals loved ones clinicians improve medical decisionmaking ensure wishes honored life courseclinicaltrialsgov nct01550731 registered 8 december 2011