Areej El?Jawahri|Susan L. Mitchell|Michael K. Paasche?Orlow|Jennifer S. Temel|Vicki A. Jackson|Renee R. Rutledge|Mihir Parikh|Aretha Delight Davis|Muriel R. Gillick|Michael J. Barry|Lenny López|Elizabeth Walker-Corkery|Yuchiao Chang|Kathleen Finn|Christopher M. Coley|Angelo E. Volandes
A Randomized Controlled Trial of a CPR and Intubation Video Decision Support Tool for Hospitalized Patients
Massachusetts General Hospital|Harvard University|Boston University|Massachusetts General Hospital|Massachusetts General Hospital|Oregon Health & Science University|University of California, San Francisco|Harvard University|Harvard University|Harvard University|Harvard University|Massachusetts General Hospital|Harvard University|Harvard University|Harvard University|Harvard University
decisions cardiopulmonary resuscitation cpr intubation core part advance care planning particularly seriously ill hospitalized patients however discussions often avoidedwe aimed examine impact video decision tool cpr intubation patients choices knowledge medical orders discussions providersthis prospective randomized trial conducted 9 march 2011 1 june 2013 internal medicine services two hospitals bostonone hundred fifty seriously ill hospitalized patients age 60 advanced illness prognosis 1 year less included mean age 76 51 womenthreeminute video describing cpr intubation plus verbal communication participants preferences physicians intervention n 75 control arm usual care n 75the primary outcome participants preferences cpr intubation immediately viewing video intervention arm secondary outcomes included orders withhold cprintubation documented discussions providers hospitalization participants knowledge cpr intubation fiveitem test range 05 higher scores indicate greater knowledgeintervention participants vs controls likely want cpr 64 vs 32 p 00001 intubation 72 vs 43 p 00001 intervention participants vs controls also likely orders withhold cpr 57 vs 19 p 00001 intubation 64 vs19 p 00001 hospital discharge documented discussions preferences 81 vs 43 p 00001 higher mean knowledge scores 411 vs 245 p 00001seriously ill patients viewed video cpr intubation likely want treatments better informed options orders forgo cpr intubation discuss preferences providersclinicaltrialsgov nct01325519 registry name prospective randomized trial using video images advance care planning seriously ill hospitalized patients