Effect of an Interactive Website to Engage Patients in Advance Care Planning in Outpatient Settings.
Ann Fam Med
; 18(2): 110-117, 2020 03.
Article
em En
| MEDLINE
| ID: mdl-32152014
ABSTRACT
PURPOSE:
Online programs may help to engage patients in advance care planning in outpatient settings. We sought to implement an online advance care planning program, PREPARE (Prepare for Your Care; http//www.prepareforyourcare.org), at home and evaluate the changes in advance care planning engagement among patients attending outpatient clinics.METHODS:
We undertook a prospective before-and-after study in 15 primary care clinics and 2 outpatient cancer centers in Canada. Patients were aged 50 years or older (primary care) or 18 years or older (cancer care) and free of cognitive impairment. They used the PREPARE website over 6 weeks, with reminders sent at 2 or 4 weeks. We used the 55-item Advance Care Planning Engagement Survey, which measures behavior change processes (knowledge, contemplation, self-efficacy, readiness) on 5-point scales and actions relating to substitute decision makers, quality of life, flexibility for the decision maker, and asking doctors questions on an overall scale from 0 to 21; higher scores indicate greater engagement.RESULTS:
In total, 315 patients were screened and 172 enrolled, of whom 75% completed the study (mean age = 65.6 years, 51% female, 35% had cancer). The mean behavior change process score was 2.9 (SD 0.8) at baseline and 3.5 (SD 0.8) at follow-up (mean change = 0.6; 95% CI, 0.49-0.73); the mean action measure score was 4.0 (SD 4.9) at baseline and 5.2 (SD 5.4) at follow-up (mean change = 1.2; 95% CI, 0.54-1.77). The effect size was moderate (0.75) for the former and small (0.23) for the latter. Findings were similar in both primary care and cancer care populations.CONCLUSIONS:
Implementation of the online PREPARE program in primary care and cancer care clinics increased advance care planning engagement among patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Participação do Paciente
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Internet
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Tomada de Decisões
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Planejamento Antecipado de Cuidados
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Qualitative_research
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article