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The goal of this research is to increase patients' knowledge about advance care planning (ACP) discussions and hospice care for patients with serious illness receiving home-based care.
ACP is a process that allows patients to communicate their wishes and preferences or medical care, when they are seriously ill, to their medical providers. The study investigators would like to assess whether a home-ACP video can improve patient-clinician communication about patients wishes for their medical care and lead to more patient-centered care.
This study is a randomized clinical trial of a Home-ACP intervention among 500 adult patients with serious illness receiving medical care at home with the Clover Health House Calls Program. Study participants will be assigned to one of two groups. In one group, participants will continue to receive usual care with their home-based care team. In the second group, participants will continue to receive their usual care with their home-based care team and also view an ACP video that helps them understand ACP and provides education about ACP and hospice care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Usual Care | No Intervention | Usual care entails receiving usual medical care by the home-based care team. | |
| Video intervention | Experimental | In addition to usual care, the intervention will entail having a visit by a trained study clinician to provide access to the ACP video. The study clinician will discuss the content of the video and answer any questions. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Home ACP Video | Behavioral | A video focused on Advance Care Planning and Hospice for patients with serious illness |
|
| Measure | Description | Time Frame |
|---|---|---|
| Hospice utilization | Compare the use of hospice (yes vs. no) between the study groups | up to one year follow-up or death |
| Measure | Description | Time Frame |
|---|---|---|
| Hospice length of stay | Compare hospice length-of-stay between the study groups | up to one year follow-up or death |
| Rates of documented resuscitation preferences in the Electronic Health Record |
| Measure | Description | Time Frame |
|---|---|---|
| Cost of care in the last year of life | Compare cost of care in the last year of life between the study groups | 1 year |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Areej El-Jawahri, MD | Contact | 617-724-4000 | ael-jawahri@partners.org |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clover Health | Recruiting | Jersey City | New Jersey | 07302 | United States |
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| ID | Term |
|---|---|
| D010342 | Patient Acceptance of Health Care |
| ID | Term |
|---|---|
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
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The research team collecting study outcomes will be blinded to group assignment
Compare documented resuscitation preferences in the Electronic Health Record between the two groups
| up to one year follow-up or death |
| Rates of Advance Care Planning documentation in the Electronic Health Record | Compare advance care planning documentation in the Electronic Health Record between the two groups | up to one year follow-up or death |
| Patient knowledge about Advance Care Planning | Compare patient's knowledge about advance care planning using a 5-item knowledge questionnaire (range 0-5), higher score indicate more knowledge | Up to two days following the intervention visit |
| Patient reported confidence in care | Compare patient's reported confidence in their medical care using a single Likert response question between the two study groups. Score range from 0-4. Higher scores indicate higher confidence in care | up to two days following the intervention visit |
| Patient reported satisfaction with clinician communication | Compare patient satisfaction with their communication with their clinician using the CAHPS subscale. Score range 0-20. Higher score indicate better satisfaction with communication | up to two days following the intervention visit |
| Patient reported decisional satisfaction | Compare patient reported decisional satisfaction between the study groups using the Satisfaction with Decision Scale. Scale range from 6-30. Higher scores indicate higher satisfaction with decision | up to two days following the intervention visit |
| Patient reported decisional certainty | Compare patient reported decisional certainty between the two groups using the Decision Conflict Scale. Score ranges from 0 to 100. Higher scores indicate higher decisional conflict | up to two days following the intervention visit |