Impact of a Nurse-Led Advance Care Planning Intervention on Satisfaction, Health-Related Quality of Life, and Health Care Utilization Among Patients With Severe Respiratory Disease: A Randomized Patient-Preference Trial
Previous work has found that facilitated advance care planning (ACP) interventions are effective in increasing ACP uptake among patients with severe respiratory disease. The objective of this study was to investigate whether a nurse-led, facilitated ACP intervention among participants with severe re...
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| Veröffentlicht in: | Journal of pain and symptom management 2020-04, Vol.59 (4), p.848-855 |
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| container_title | Journal of pain and symptom management |
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| creator | Sinclair, Craig Auret, Kirsten Anne Evans, Sharon Frances Jane, Fiona Dormer, Siobhan Wilkinson, Anne Greeve, Kim Koay, M. Audrey Brims, Fraser |
| description | Previous work has found that facilitated advance care planning (ACP) interventions are effective in increasing ACP uptake among patients with severe respiratory disease.
The objective of this study was to investigate whether a nurse-led, facilitated ACP intervention among participants with severe respiratory disease impacts self-reported or clinical outcomes.
A multicenter, open-label, patient-preference, randomized controlled trial of a nurse-led facilitated ACP intervention was performed. Outcome measures included self-report scales (health care satisfaction and EQ-5D-5L health-related quality of life at three- and six-month follow-up), 12-month mortality, and health care utilization during the final 90 days of life.
One hundred forty-nine participants were recruited across two study settings (metropolitan tertiary hospital respiratory department and rural sites) and 106 were allocated to receive the ACP intervention. There was no effect of the intervention on satisfaction with health care, health-related quality of life, or 12-month mortality rates. Among those participants who died during the follow-up period (N = 54), those allocated to the ACP intervention had significantly fewer outpatient consultations (7.51 vs. 13.6, P |
| doi_str_mv | 10.1016/j.jpainsymman.2019.11.018 |
| format | Article |
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The objective of this study was to investigate whether a nurse-led, facilitated ACP intervention among participants with severe respiratory disease impacts self-reported or clinical outcomes.
A multicenter, open-label, patient-preference, randomized controlled trial of a nurse-led facilitated ACP intervention was performed. Outcome measures included self-report scales (health care satisfaction and EQ-5D-5L health-related quality of life at three- and six-month follow-up), 12-month mortality, and health care utilization during the final 90 days of life.
One hundred forty-nine participants were recruited across two study settings (metropolitan tertiary hospital respiratory department and rural sites) and 106 were allocated to receive the ACP intervention. There was no effect of the intervention on satisfaction with health care, health-related quality of life, or 12-month mortality rates. Among those participants who died during the follow-up period (N = 54), those allocated to the ACP intervention had significantly fewer outpatient consultations (7.51 vs. 13.6, P < 0.001). There were no changes in emergency department attendances, total hospital admissions or length of stay, or home nursing visits. Among those allocated to the ACP intervention, there was a reduced length of stay in acute hospital settings (7.76 vs. 11.5 nights, P < 0.001) and increased length of stay in palliative hospital settings (5.54 vs. 2.08, P < 0.001) during the final 90 days of life.
A facilitated ACP intervention among patients with severe respiratory disease did not have an impact on satisfaction, health-related quality of life, or 12-month mortality rate. Facilitated ACP may be associated with a different type of health care utilization during the end-of-life period.</description><identifier>ISSN: 0885-3924</identifier><identifier>EISSN: 1873-6513</identifier><identifier>DOI: 10.1016/j.jpainsymman.2019.11.018</identifier><identifier>PMID: 31790750</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Advance care planning ; Advance directives ; Care plans ; Clinical outcomes ; Clinical trials ; Emergency services ; End of life decisions ; health care utilization ; Health services utilization ; Health status ; Home health care ; Hospitalization ; Intervention ; Length of stay ; Mortality ; Mortality rates ; Nurse led care ; Nurse led services ; Palliative care ; Patients ; Quality of life ; respiratory disease ; Respiratory diseases ; satisfaction ; Self report ; Severity ; survival analysis ; Uptake</subject><ispartof>Journal of pain and symptom management, 2020-04, Vol.59 (4), p.848-855</ispartof><rights>2019 American Academy of Hospice and Palliative Medicine</rights><rights>Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Apr 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-e9fd35112a656c47ea9d6580994f271c7b88e5c85c1120ed329e5cbcdfd3d1753</citedby><cites>FETCH-LOGICAL-c456t-e9fd35112a656c47ea9d6580994f271c7b88e5c85c1120ed329e5cbcdfd3d1753</cites><orcidid>0000-0002-6725-7535</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0885392419306736$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,30978,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31790750$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sinclair, Craig</creatorcontrib><creatorcontrib>Auret, Kirsten Anne</creatorcontrib><creatorcontrib>Evans, Sharon Frances</creatorcontrib><creatorcontrib>Jane, Fiona</creatorcontrib><creatorcontrib>Dormer, Siobhan</creatorcontrib><creatorcontrib>Wilkinson, Anne</creatorcontrib><creatorcontrib>Greeve, Kim</creatorcontrib><creatorcontrib>Koay, M. Audrey</creatorcontrib><creatorcontrib>Brims, Fraser</creatorcontrib><title>Impact of a Nurse-Led Advance Care Planning Intervention on Satisfaction, Health-Related Quality of Life, and Health Care Utilization Among Patients With Severe Respiratory Disease: A Randomized Patient-Preference Trial</title><title>Journal of pain and symptom management</title><addtitle>J Pain Symptom Manage</addtitle><description>Previous work has found that facilitated advance care planning (ACP) interventions are effective in increasing ACP uptake among patients with severe respiratory disease.
The objective of this study was to investigate whether a nurse-led, facilitated ACP intervention among participants with severe respiratory disease impacts self-reported or clinical outcomes.
A multicenter, open-label, patient-preference, randomized controlled trial of a nurse-led facilitated ACP intervention was performed. Outcome measures included self-report scales (health care satisfaction and EQ-5D-5L health-related quality of life at three- and six-month follow-up), 12-month mortality, and health care utilization during the final 90 days of life.
One hundred forty-nine participants were recruited across two study settings (metropolitan tertiary hospital respiratory department and rural sites) and 106 were allocated to receive the ACP intervention. There was no effect of the intervention on satisfaction with health care, health-related quality of life, or 12-month mortality rates. Among those participants who died during the follow-up period (N = 54), those allocated to the ACP intervention had significantly fewer outpatient consultations (7.51 vs. 13.6, P < 0.001). There were no changes in emergency department attendances, total hospital admissions or length of stay, or home nursing visits. Among those allocated to the ACP intervention, there was a reduced length of stay in acute hospital settings (7.76 vs. 11.5 nights, P < 0.001) and increased length of stay in palliative hospital settings (5.54 vs. 2.08, P < 0.001) during the final 90 days of life.
A facilitated ACP intervention among patients with severe respiratory disease did not have an impact on satisfaction, health-related quality of life, or 12-month mortality rate. Facilitated ACP may be associated with a different type of health care utilization during the end-of-life period.</description><subject>Advance care planning</subject><subject>Advance directives</subject><subject>Care plans</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Emergency services</subject><subject>End of life decisions</subject><subject>health care utilization</subject><subject>Health services utilization</subject><subject>Health status</subject><subject>Home health care</subject><subject>Hospitalization</subject><subject>Intervention</subject><subject>Length of stay</subject><subject>Mortality</subject><subject>Mortality rates</subject><subject>Nurse led care</subject><subject>Nurse led services</subject><subject>Palliative care</subject><subject>Patients</subject><subject>Quality of life</subject><subject>respiratory disease</subject><subject>Respiratory diseases</subject><subject>satisfaction</subject><subject>Self report</subject><subject>Severity</subject><subject>survival analysis</subject><subject>Uptake</subject><issn>0885-3924</issn><issn>1873-6513</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqNktuO0zAQhiMEYsvCKyAjbrjYBDuOc-CuKoetVEHp7opLy7Un4Cpxiu1U6r4qL8OEFoS4QooSjfT939iTSZIXjGaMsvL1LtvtlXXh2PfKZTllTcZYRln9IJmxuuJpKRh_mMxoXYuUN3lxkTwJYUcpFbzkj5MLzqqGVoLOkh_Lfq90JENLFPk4-gDpCgyZm4NyGshCeSDrTjln3VeydBH8AVy0gyP43KhoQ4txrK_INagufks30KmIis-j6mw8TuaVbeGKKGfOzEl7F21n79Uv2bwf0L_GAu2BfLEI3cABENtA2Fuv4uCP5K0NoAK8IXOyQd3Q23vsdI6law8tJqZz33qruqfJo1Z1AZ6dv5fJ3ft3t4vrdPXpw3IxX6W6EGVMoWkNF4zlqhSlLipQjSlFTZumaPOK6Wpb1yB0LTQyFAzPGyy32mDMsErwy-TVybv3w_cRQpS9DRo6HBsMY5A5z2ld4btC9OU_6G4YvcPTybzgdZ6zgk7C5kRpP4SAt5J7b3vlj5JROW2A3Mm_NkBOGyAZk7gBmH1-7jBuezB_kr9_OQKLEwA4koMFL4O209CM9aCjNIP9jzY_ARXyyyE</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Sinclair, Craig</creator><creator>Auret, Kirsten Anne</creator><creator>Evans, Sharon Frances</creator><creator>Jane, Fiona</creator><creator>Dormer, Siobhan</creator><creator>Wilkinson, Anne</creator><creator>Greeve, Kim</creator><creator>Koay, M. 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Audrey</creatorcontrib><creatorcontrib>Brims, Fraser</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pain and symptom management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sinclair, Craig</au><au>Auret, Kirsten Anne</au><au>Evans, Sharon Frances</au><au>Jane, Fiona</au><au>Dormer, Siobhan</au><au>Wilkinson, Anne</au><au>Greeve, Kim</au><au>Koay, M. Audrey</au><au>Brims, Fraser</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of a Nurse-Led Advance Care Planning Intervention on Satisfaction, Health-Related Quality of Life, and Health Care Utilization Among Patients With Severe Respiratory Disease: A Randomized Patient-Preference Trial</atitle><jtitle>Journal of pain and symptom management</jtitle><addtitle>J Pain Symptom Manage</addtitle><date>2020-04</date><risdate>2020</risdate><volume>59</volume><issue>4</issue><spage>848</spage><epage>855</epage><pages>848-855</pages><issn>0885-3924</issn><eissn>1873-6513</eissn><abstract>Previous work has found that facilitated advance care planning (ACP) interventions are effective in increasing ACP uptake among patients with severe respiratory disease.
The objective of this study was to investigate whether a nurse-led, facilitated ACP intervention among participants with severe respiratory disease impacts self-reported or clinical outcomes.
A multicenter, open-label, patient-preference, randomized controlled trial of a nurse-led facilitated ACP intervention was performed. Outcome measures included self-report scales (health care satisfaction and EQ-5D-5L health-related quality of life at three- and six-month follow-up), 12-month mortality, and health care utilization during the final 90 days of life.
One hundred forty-nine participants were recruited across two study settings (metropolitan tertiary hospital respiratory department and rural sites) and 106 were allocated to receive the ACP intervention. There was no effect of the intervention on satisfaction with health care, health-related quality of life, or 12-month mortality rates. Among those participants who died during the follow-up period (N = 54), those allocated to the ACP intervention had significantly fewer outpatient consultations (7.51 vs. 13.6, P < 0.001). There were no changes in emergency department attendances, total hospital admissions or length of stay, or home nursing visits. Among those allocated to the ACP intervention, there was a reduced length of stay in acute hospital settings (7.76 vs. 11.5 nights, P < 0.001) and increased length of stay in palliative hospital settings (5.54 vs. 2.08, P < 0.001) during the final 90 days of life.
A facilitated ACP intervention among patients with severe respiratory disease did not have an impact on satisfaction, health-related quality of life, or 12-month mortality rate. Facilitated ACP may be associated with a different type of health care utilization during the end-of-life period.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31790750</pmid><doi>10.1016/j.jpainsymman.2019.11.018</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6725-7535</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of pain and symptom management, 2020-04, Vol.59 (4), p.848-855 |
| issn | 0885-3924 1873-6513 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Elsevier ScienceDirect Journals |
| subjects | Advance care planning Advance directives Care plans Clinical outcomes Clinical trials Emergency services End of life decisions health care utilization Health services utilization Health status Home health care Hospitalization Intervention Length of stay Mortality Mortality rates Nurse led care Nurse led services Palliative care Patients Quality of life respiratory disease Respiratory diseases satisfaction Self report Severity survival analysis Uptake |
| title | Impact of a Nurse-Led Advance Care Planning Intervention on Satisfaction, Health-Related Quality of Life, and Health Care Utilization Among Patients With Severe Respiratory Disease: A Randomized Patient-Preference Trial |
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