A cluster randomized controlled trial on the effects and costs of advance care planning in elderly care: study protocol

BMC Geriatrics

Agnes van der Heide³  Frederika E. Witkamp³  Siebe J. Swart¹  Johan Severijnen¹  Suzanne Polinder³  Ellen Hansen-van der Meer¹  Bernard J. Hammes²  Pascalle Billekens¹  Lea J. Jabbarian³  Anouk Overbeek³  Judith A.C. Rietjens³  Ida J. Korfage³ 

[1] Laurens, Rotterdam, The Netherlands;Gundersen Lutheran Medical Foundation, La Crosse, WI, USA;Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands

关键词: Patient activation;    Quality of life;    Cost-effectiveness;    Elderly care;    Respecting choices;    Advance directives;    Advance care planning;   

Others  :  1220848
DOI  :  10.1186/s12877-015-0087-z

 received in 2015-04-10, accepted in 2015-07-13,  发布年份 2015

【 摘 要 】

Background

Currently, health care and medical decision-making at the end of life for older people are often insufficiently patient-centred. In this trial we study the effects of Advance Care Planning (ACP), a formalised process of timely communication about care preferences at the end of life, for frail older people.

Methods/Design

We will conduct a cluster randomised controlled trial among older people residing in care homes or receiving home care in the Netherlands. The intervention group will receive the ACP program Respecting Choices® in addition to usual care. The control group will receive usual care only. Participants in both groups will fill out questionnaires at baseline and after 12 months. We hypothesize that ACP will lead to better patient activation in medical decision making and quality of life, while reducing the number of medical interventions and thus health care costs. Multivariate analysis will be used to compare differences between the intervention group and the control group at baseline and to compare differences in changes after 12 months following the inclusion.

Discussion

Our study can contribute to more understanding of the effects of ACP on patient activation and quality of life in frail older people. Further, we will gain insight in the costs and cost-effectiveness of ACP. This study will facilitate ACP policy for older people in the Netherlands.

Trial registration

Nederlands Trial Register: NTR4454.

【 授权许可】

   
2015 Korfage et al.

【 图 表 】

Fig. 1.

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