Hillary D. Lum|Deborah E. Barnes|Mary Katen|Ying Shi|John Boscardin|Rebecca L. Sudore
Improving a Full Range of Advance Care Planning Behavior Change and Action Domains: The PREPARE Randomized Trial
University of Colorado Anschutz Medical Campus|University of Colorado Denver|Geriatric Research Education and Clinical Center|University of California, San Francisco|San Francisco VA Health Care System|University of California, San Francisco|San Francisco VA Health Care System|University of California, San Francisco|San Francisco VA Health Care System|University of California, San Francisco|University of California, San Francisco|San Francisco VA Health Care System
advance care planning acp engagement includes wide range behaviors actions related discussions documentation yet acp intervention studies measure full processthe objective study compare effects easytoread advance directive ad versus acp web site plus ad prepare ad behavior change processes actions including discussions documentationsecondary data completed acp trial participants primary care patients 60 years old two comorbidities used validated acp engagement survey examine sixmonth change subscales measuring behavior change processes knowledge contemplation selfefficacy readiness actions decision makers quality life flexibility decision makers asking clinicians questions specifically related discussions documentation used adjusted mixedeffects linear models compare mean change engagement timecompared adonly prepare ad resulted greater increases behavior change processes subscales actions related decision makers quality life flexibility pvalues 0005 interventions significantly increased proportion participants engaged acp discussions prepare ad 995 adonly 933 documentation prepare ad 995 adonly 904 greater increases prepare ad pvalues 0001both prepare plus easytoread ad adonly markedly increased acp engagement full range acp behaviors including discussions documentation engagement nearly 100 prepare ad future acp studies examine full range acp behaviors beyond ads impact prepare easytoread ad implementation health care systems