An intervention to increase advance care planning among older adults with advanced cancer-A randomized clinical trial

An intervention to increase advance care planning among older adults with advanced cancer-A randomized clinical trial
JAMA Network Open; by Angelo E. Volandes, Yuchiao Chang, Joshua R. Lakin, Michael K. Paasche-Orlow, Charlotta Lindvall, Seth N. Zupanc, Diana Martins-Welch, Maria T. Carney, Edith A. Burns, Jennifer Itty, Kaitlin Emmert-Tangredi, Narda J. Martin, Shreya Sanghani, Jon Tilburt, Kathryn I. Pollak, Aretha Delight Davis, Cynthia Garde, Michael J. Barry, Areej El-Jawahri, Lisa Quintiliani, Kate Sciacca, Julie Goldman, James A. Tulsky; 5/25
Despite accumulating evidence of the benefits of these discussions, documentation of advance care planning (ACP) activity in the electronic health record (EHR) remains low and inconsistent for most health care systems, increasing the risk that patients will not receive care that matches their goals. In this pragmatic stepped-wedge randomized clinical trial among older patients with advanced cancer, an intervention combining patient video decision aids and clinician communication skills training increased the proportion of patients with ACP documentation. This randomized clinical trial exploring a combined intervention of patient empowerment and clinician communication skills training found a significant and clinically meaningful increase in ACP documentation rates with a scalable intervention that can be rapidly implemented across large health care systems. This approach offers an innovative paradigm with a clinically meaningful increase in ACP documentation, a widely used quality metric that reflects high-quality patient-centered care delivery.