scholarly journals Effectiveness of Advance Care Planning Group Visits Among Older Adults in Primary Care

2020 ◽  
Vol 68 (10) ◽  
pp. 2382-2389
Author(s):  
Hillary D. Lum ◽  
Joanna Dukes ◽  
Andrea E. Daddato ◽  
Elizabeth Juarez‐Colunga ◽  
Prajakta Shanbhag ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Group Visits ◽  
Advance Care ◽  
Planning Group

scholarly journals Primary care provider‐led group visits for advance care planning in the safety net

2021 ◽  
Author(s):  
Heather B. Schickedanz ◽  
Rhonda Polzin ◽  
Stefanie D. Vassar ◽  
Arleen F. Brown ◽  
Karen J. Kim
Keyword(s):  
Primary Care ◽  
Advance Care Planning ◽  
Care Provider ◽  
Primary Care Provider ◽  
Safety Net ◽  
Care Planning ◽  
Group Visits ◽  
Advance Care

scholarly journals Group-based educational intervention for advance care planning in primary care: a quasi-experimental study in Japan

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Shuji Tsuda ◽  
Mary R. Janevic ◽  
Kota Shikano ◽  
Tomoko Matsui ◽  
Tsukasa Tsuda
Keyword(s):  
Primary Care ◽  
Advance Care Planning ◽  
Advance Directive ◽  
Future Research ◽  
Care Planning ◽  
Group Discussions ◽  
Quasi Experimental ◽  
Advance Care ◽  
The Individual ◽  
Planning Group

Background: Older adults who have health conditions with good prognoses typically fall outside the scope of efforts encouraging advance care planning. We developed group and individual versions of an advance care planning program for use in primary care. Methods: We conducted a quasi-experimental trial in a rural family clinic in Japan. Medically stable patients aged ≥65 years were invited to watch an educational video on advance care planning, followed by an individual (n=46) or group-based (n=63) discussion. Advance directive completion was tracked over four months. Participants completed baseline and follow-up questionnaires and reported occurrence of family discussions about advance care planning and attitudes toward advance care planning. Group discussions were recorded and thematically analyzed to identify barriers and facilitators to engaging in advance care planning. Results: Advance directive completion rates were high for both intervention versions but did not significantly differ between arms (85.7% vs. 80.4%, p=0.45). Only one-fifth of patients in both arms discussed advance care planning with their family after the intervention (20.7% and 21.7%, p=0.89). Patients in the group arm rated their experience slightly higher than those in the individual arm (4.2 and 3.9 out of 5, p=0.023). Qualitative analysis of group discussions revealed that patients were affected by their perceptions of societal norms that prioritize family consensus over patient autonomy; however, these perceptions influenced advance care planning behaviors in inconsistent ways. Conclusions: Group-based advance care planning intervention among medically stable older patients is as effective as an individually-focused discussion in promoting advance directive completion. Future research is needed on ways to enhance patients’ ability to discuss advance care planning with their family members.

scholarly journals A Group Visit Initiative Improves Advance Care Planning Documentation among Older Adults in Primary Care

2017 ◽  
Vol 30 (4) ◽  
pp. 480-490 ◽  
Author(s):  
Hillary D. Lum ◽  
Rebecca L. Sudore ◽  
Daniel D. Matlock ◽  
Elizabeth Juarez-Colunga ◽  
Jacqueline Jones ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Group Visit ◽  
Advance Care

SHARING Choices: A Pilot Study to Engage Family in Advance Care Planning of Older Adults With and Without Cognitive Impairment in the Primary Care Context

2020 ◽  
pp. 104990912097877
Author(s):  
Jennifer L. Wolff ◽  
Danny Scerpella ◽  
Kimberly Cockey ◽  
Naaz Hussain ◽  
Tara Funkhouser ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Advance Care Planning ◽  
Advance Directive ◽  
Agenda Setting ◽  
Care Planning ◽  
Future Care ◽  
Advance Care ◽  
Electronic Health Information

Context: Few advance care planning (ACP) interventions proactively engage family or address the needs of older adults with and without cognitive impairment in the primary care context. Objectives: To pilot a multicomponent intervention involving: an introductory letter describing a new clinic initiative and inviting patients to complete a patient-family pre-visit agenda-setting checklist, share their electronic health information with family, and talk about their wishes for future care with a trained ACP facilitator (SHARING Choices). Methods: SHARING Choices was delivered to 40 patient-family dyads from 3 primary care clinics. Facilitators completed post-ACP reports. Patient and family participants completed baseline and 6-week surveys. Results: Patients were on average 75 years (range 65-90). Family were spouses (85.0%) or adult children (15.0%). At 6 weeks, nearly half of dyads participated in ACP conversations (n = 19) or used the agenda-setting checklist (n = 17), one-third (n = 13) registered family to access the patient’s portal account, and most (n = 28) provided the primary care team with a new or previously completed advance directive. Of 12 patients who screened positive for cognitive impairment, 9 completed ACP conversations and 10 provided the clinic with an advance directive. ACP engagement, measured on a 4-point scale, was comparatively lower at baseline and 6 weeks among family (3.05 and 3.19) than patients (3.56 and 3.54). Patients remarked that SHARING Choices clarified communication and preferences while family reported a better understanding of their role in ACP and communication. Conclusion: SHARING Choices was acceptable among older adults with and without cognitive impairment and may increase advance directive completion.

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