Advance Care Planning in Frail Older Adults: A Cluster Randomized Controlled Trial
Objectives To determine the effectiveness of advance care planning (ACP) in frail older adults. Design Cluster randomized controlled trial. Setting Residential care homes in the Netherlands (N=16). Participants Care home residents and community‐dwelling adults receiving home care (N=201; n=101 inter...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2018-06, Vol.66 (6), p.1089-1095 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
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| creator | Overbeek, Anouk Korfage, Ida J. Jabbarian, Lea J. Billekens, Pascalle Hammes, Bernard J. Polinder, Suzanne Severijnen, Johan Swart, Siebe J. Witkamp, Frederika E. van der Heide, Agnes Rietjens, Judith A.C. |
| description | Objectives
To determine the effectiveness of advance care planning (ACP) in frail older adults.
Design
Cluster randomized controlled trial.
Setting
Residential care homes in the Netherlands (N=16).
Participants
Care home residents and community‐dwelling adults receiving home care (N=201; n=101 intervention; n=100 control). Participants were 75 years and older, frail, and capable of consenting to participation.
Intervention
Adjusted Respecting Choices ACP program.
Measurements
The primary outcome was change in patient activation (Patient Activation Measure, PAM‐13) between baseline and 12‐month follow‐up. Secondary outcomes included change in quality of life (SF‐12), advance directive (AD) completion, and surrogate decision‐maker appointment. Use of medical care in the 12 months after inclusion was also assessed. Multilevel analyses were performed, controlling for clustering effects and differences in demographics.
Results
Seventy‐seven intervention participants and 83 controls completed the follow‐up assessment. There were no statistically significant differences between the intervention (–0.26±11.2) and control group (–1.43±10.6) in change scores of the PAM (p=.43) or the SF‐12. Of intervention group participants, 93% completed an AD, and 94% appointed a decision‐maker. Of control participants, 34% completed an AD, and 67% appointed a decision‐maker (p |
| doi_str_mv | 10.1111/jgs.15333 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2021319069</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2070958790</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3533-aa978c04412c46b6f5cb732b966d43cc2b174d91ab3e0e207aeff7ef7e3d6cbd3</originalsourceid><addsrcrecordid>eNp1kF1LwzAUhoMobn5c-Ack4I1edMtHmzbeleKmMpjMeV3SJB0daTuTVZm_3minF4KHA-dweHh5zwvABUYj7Gu8XrkRjiilB2DoJwmiEEeHYIgQIkHCcDgAJ86tEcIEJckxGBDOUBInfAgWqXoTjdQwE1bDJyOapmpWsGrgxIrKwLlR2sJUdWbrbmEKM9O5rb8sRKPauvrQCmZts7WtMX5d2kqYM3BUCuP0-X6egpfJ3TK7D2bz6UOWzgJJvddACB4nEoUhJjJkBSsjWcSUFJwxFVIpSYHjUHEsCqqRJigWuixj7ZsqJgtFT8F1r7ux7Wun3TavKye18T_otnM5QQRTzBHjHr36g67bzjbenadixKMk5shTNz0lbeuc1WW-sVUt7C7HKP8KOvdB599Be_Zyr9gVtVa_5E-yHhj3wHtl9O5_pfxx-txLfgKWUoX0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2070958790</pqid></control><display><type>article</type><title>Advance Care Planning in Frail Older Adults: A Cluster Randomized Controlled Trial</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Overbeek, Anouk ; Korfage, Ida J. ; Jabbarian, Lea J. ; Billekens, Pascalle ; Hammes, Bernard J. ; Polinder, Suzanne ; Severijnen, Johan ; Swart, Siebe J. ; Witkamp, Frederika E. ; van der Heide, Agnes ; Rietjens, Judith A.C.</creator><creatorcontrib>Overbeek, Anouk ; Korfage, Ida J. ; Jabbarian, Lea J. ; Billekens, Pascalle ; Hammes, Bernard J. ; Polinder, Suzanne ; Severijnen, Johan ; Swart, Siebe J. ; Witkamp, Frederika E. ; van der Heide, Agnes ; Rietjens, Judith A.C.</creatorcontrib><description>Objectives
To determine the effectiveness of advance care planning (ACP) in frail older adults.
Design
Cluster randomized controlled trial.
Setting
Residential care homes in the Netherlands (N=16).
Participants
Care home residents and community‐dwelling adults receiving home care (N=201; n=101 intervention; n=100 control). Participants were 75 years and older, frail, and capable of consenting to participation.
Intervention
Adjusted Respecting Choices ACP program.
Measurements
The primary outcome was change in patient activation (Patient Activation Measure, PAM‐13) between baseline and 12‐month follow‐up. Secondary outcomes included change in quality of life (SF‐12), advance directive (AD) completion, and surrogate decision‐maker appointment. Use of medical care in the 12 months after inclusion was also assessed. Multilevel analyses were performed, controlling for clustering effects and differences in demographics.
Results
Seventy‐seven intervention participants and 83 controls completed the follow‐up assessment. There were no statistically significant differences between the intervention (–0.26±11.2) and control group (–1.43±10.6) in change scores of the PAM (p=.43) or the SF‐12. Of intervention group participants, 93% completed an AD, and 94% appointed a decision‐maker. Of control participants, 34% completed an AD, and 67% appointed a decision‐maker (p<.001). No differences in the use of medical care were found.
Conclusions
ACP did not increase levels of patient activation or quality of life but did increase completion of ADs and appointment of surrogate decision‐makers. It did not affect use of medical care.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.15333</identifier><identifier>PMID: 29608789</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>advance care planning ; Advance directives ; Clinical trials ; Demography ; frailty ; older adults ; Older people ; patient activation ; Quality of life ; randomized controlled trial ; Statistical analysis</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2018-06, Vol.66 (6), p.1089-1095</ispartof><rights>2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society</rights><rights>2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.</rights><rights>2018, American Geriatrics Society and Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3533-aa978c04412c46b6f5cb732b966d43cc2b174d91ab3e0e207aeff7ef7e3d6cbd3</citedby><cites>FETCH-LOGICAL-c3533-aa978c04412c46b6f5cb732b966d43cc2b174d91ab3e0e207aeff7ef7e3d6cbd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.15333$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.15333$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29608789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Overbeek, Anouk</creatorcontrib><creatorcontrib>Korfage, Ida J.</creatorcontrib><creatorcontrib>Jabbarian, Lea J.</creatorcontrib><creatorcontrib>Billekens, Pascalle</creatorcontrib><creatorcontrib>Hammes, Bernard J.</creatorcontrib><creatorcontrib>Polinder, Suzanne</creatorcontrib><creatorcontrib>Severijnen, Johan</creatorcontrib><creatorcontrib>Swart, Siebe J.</creatorcontrib><creatorcontrib>Witkamp, Frederika E.</creatorcontrib><creatorcontrib>van der Heide, Agnes</creatorcontrib><creatorcontrib>Rietjens, Judith A.C.</creatorcontrib><title>Advance Care Planning in Frail Older Adults: A Cluster Randomized Controlled Trial</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>Objectives
To determine the effectiveness of advance care planning (ACP) in frail older adults.
Design
Cluster randomized controlled trial.
Setting
Residential care homes in the Netherlands (N=16).
Participants
Care home residents and community‐dwelling adults receiving home care (N=201; n=101 intervention; n=100 control). Participants were 75 years and older, frail, and capable of consenting to participation.
Intervention
Adjusted Respecting Choices ACP program.
Measurements
The primary outcome was change in patient activation (Patient Activation Measure, PAM‐13) between baseline and 12‐month follow‐up. Secondary outcomes included change in quality of life (SF‐12), advance directive (AD) completion, and surrogate decision‐maker appointment. Use of medical care in the 12 months after inclusion was also assessed. Multilevel analyses were performed, controlling for clustering effects and differences in demographics.
Results
Seventy‐seven intervention participants and 83 controls completed the follow‐up assessment. There were no statistically significant differences between the intervention (–0.26±11.2) and control group (–1.43±10.6) in change scores of the PAM (p=.43) or the SF‐12. Of intervention group participants, 93% completed an AD, and 94% appointed a decision‐maker. Of control participants, 34% completed an AD, and 67% appointed a decision‐maker (p<.001). No differences in the use of medical care were found.
Conclusions
ACP did not increase levels of patient activation or quality of life but did increase completion of ADs and appointment of surrogate decision‐makers. It did not affect use of medical care.</description><subject>advance care planning</subject><subject>Advance directives</subject><subject>Clinical trials</subject><subject>Demography</subject><subject>frailty</subject><subject>older adults</subject><subject>Older people</subject><subject>patient activation</subject><subject>Quality of life</subject><subject>randomized controlled trial</subject><subject>Statistical analysis</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kF1LwzAUhoMobn5c-Ack4I1edMtHmzbeleKmMpjMeV3SJB0daTuTVZm_3minF4KHA-dweHh5zwvABUYj7Gu8XrkRjiilB2DoJwmiEEeHYIgQIkHCcDgAJ86tEcIEJckxGBDOUBInfAgWqXoTjdQwE1bDJyOapmpWsGrgxIrKwLlR2sJUdWbrbmEKM9O5rb8sRKPauvrQCmZts7WtMX5d2kqYM3BUCuP0-X6egpfJ3TK7D2bz6UOWzgJJvddACB4nEoUhJjJkBSsjWcSUFJwxFVIpSYHjUHEsCqqRJigWuixj7ZsqJgtFT8F1r7ux7Wun3TavKye18T_otnM5QQRTzBHjHr36g67bzjbenadixKMk5shTNz0lbeuc1WW-sVUt7C7HKP8KOvdB599Be_Zyr9gVtVa_5E-yHhj3wHtl9O5_pfxx-txLfgKWUoX0</recordid><startdate>201806</startdate><enddate>201806</enddate><creator>Overbeek, Anouk</creator><creator>Korfage, Ida J.</creator><creator>Jabbarian, Lea J.</creator><creator>Billekens, Pascalle</creator><creator>Hammes, Bernard J.</creator><creator>Polinder, Suzanne</creator><creator>Severijnen, Johan</creator><creator>Swart, Siebe J.</creator><creator>Witkamp, Frederika E.</creator><creator>van der Heide, Agnes</creator><creator>Rietjens, Judith A.C.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201806</creationdate><title>Advance Care Planning in Frail Older Adults: A Cluster Randomized Controlled Trial</title><author>Overbeek, Anouk ; Korfage, Ida J. ; Jabbarian, Lea J. ; Billekens, Pascalle ; Hammes, Bernard J. ; Polinder, Suzanne ; Severijnen, Johan ; Swart, Siebe J. ; Witkamp, Frederika E. ; van der Heide, Agnes ; Rietjens, Judith A.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3533-aa978c04412c46b6f5cb732b966d43cc2b174d91ab3e0e207aeff7ef7e3d6cbd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>advance care planning</topic><topic>Advance directives</topic><topic>Clinical trials</topic><topic>Demography</topic><topic>frailty</topic><topic>older adults</topic><topic>Older people</topic><topic>patient activation</topic><topic>Quality of life</topic><topic>randomized controlled trial</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Overbeek, Anouk</creatorcontrib><creatorcontrib>Korfage, Ida J.</creatorcontrib><creatorcontrib>Jabbarian, Lea J.</creatorcontrib><creatorcontrib>Billekens, Pascalle</creatorcontrib><creatorcontrib>Hammes, Bernard J.</creatorcontrib><creatorcontrib>Polinder, Suzanne</creatorcontrib><creatorcontrib>Severijnen, Johan</creatorcontrib><creatorcontrib>Swart, Siebe J.</creatorcontrib><creatorcontrib>Witkamp, Frederika E.</creatorcontrib><creatorcontrib>van der Heide, Agnes</creatorcontrib><creatorcontrib>Rietjens, Judith A.C.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Overbeek, Anouk</au><au>Korfage, Ida J.</au><au>Jabbarian, Lea J.</au><au>Billekens, Pascalle</au><au>Hammes, Bernard J.</au><au>Polinder, Suzanne</au><au>Severijnen, Johan</au><au>Swart, Siebe J.</au><au>Witkamp, Frederika E.</au><au>van der Heide, Agnes</au><au>Rietjens, Judith A.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advance Care Planning in Frail Older Adults: A Cluster Randomized Controlled Trial</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2018-06</date><risdate>2018</risdate><volume>66</volume><issue>6</issue><spage>1089</spage><epage>1095</epage><pages>1089-1095</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><abstract>Objectives
To determine the effectiveness of advance care planning (ACP) in frail older adults.
Design
Cluster randomized controlled trial.
Setting
Residential care homes in the Netherlands (N=16).
Participants
Care home residents and community‐dwelling adults receiving home care (N=201; n=101 intervention; n=100 control). Participants were 75 years and older, frail, and capable of consenting to participation.
Intervention
Adjusted Respecting Choices ACP program.
Measurements
The primary outcome was change in patient activation (Patient Activation Measure, PAM‐13) between baseline and 12‐month follow‐up. Secondary outcomes included change in quality of life (SF‐12), advance directive (AD) completion, and surrogate decision‐maker appointment. Use of medical care in the 12 months after inclusion was also assessed. Multilevel analyses were performed, controlling for clustering effects and differences in demographics.
Results
Seventy‐seven intervention participants and 83 controls completed the follow‐up assessment. There were no statistically significant differences between the intervention (–0.26±11.2) and control group (–1.43±10.6) in change scores of the PAM (p=.43) or the SF‐12. Of intervention group participants, 93% completed an AD, and 94% appointed a decision‐maker. Of control participants, 34% completed an AD, and 67% appointed a decision‐maker (p<.001). No differences in the use of medical care were found.
Conclusions
ACP did not increase levels of patient activation or quality of life but did increase completion of ADs and appointment of surrogate decision‐makers. It did not affect use of medical care.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29608789</pmid><doi>10.1111/jgs.15333</doi><tpages>7</tpages></addata></record> |
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| ispartof | Journal of the American Geriatrics Society (JAGS), 2018-06, Vol.66 (6), p.1089-1095 |
| issn | 0002-8614 1532-5415 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2021319069 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | advance care planning Advance directives Clinical trials Demography frailty older adults Older people patient activation Quality of life randomized controlled trial Statistical analysis |
| title | Advance Care Planning in Frail Older Adults: A Cluster Randomized Controlled Trial |
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