Effectiveness of initiating advance care planning among older outpatients through intervention by physicians trained in a model discussion video: A randomized controlled trial
Aim This study aimed to assess the impact of a physician‐led intervention on advance care planning (ACP) introduction among older outpatients using a model discussion video. Methods This prospective interventional study included Japanese general practice outpatients aged ≥65 years. All participants...
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| Veröffentlicht in: | Geriatrics & gerontology international 2024-09, Vol.24 (9), p.859-866 |
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| creator | Yoshihara‐Kurihara, Hanako Hori, Hiroshi Fuse, Aya Kurihara, Ibuki Sueda, Keishiro Fukuchi, Takahiko Mori, Masanori Sugawara, Hitoshi |
| description | Aim
This study aimed to assess the impact of a physician‐led intervention on advance care planning (ACP) introduction among older outpatients using a model discussion video.
Methods
This prospective interventional study included Japanese general practice outpatients aged ≥65 years. All participants received an ACP leaflet. Co‐researchers were trained using a model discussion video based on the “Serious Illness Conversation Guide,” and provided ACP introduction explanations to the intervention group to ensure intervention content consistency. The control group received the ACP leaflet only, with no standardized explanations. The primary outcome was ACP discussion occurrence. Secondary outcomes included ACP engagement (assessed through the 4‐item ACP Engagement Survey), engagement score for advance directives acquisition and score for surrogate decision‐maker identification, and anxiety incidence (assessed through Generalized Anxiety Disorder‐7).
Results
This study included 48 participants: 25 (52.1%) in the intervention group and 23 (47.9%) in the control group. Regarding primary outcome, the intervention group had significantly more ACP discussions compared with the control group (92.0% vs 26.1%, adjusted odds ratio 50.2, P = 0.0012). Regarding secondary outcomes, the intervention group showed greater readiness (mean scores for the 4‐item Engagement Survey [P = 0.0001], engagement score for advance directives acquisition [P = 0.01] and score for surrogate decision‐maker determination [P = 0.03]) than the control group, without increasing anxiety.
Conclusions
This physician‐led ACP introduction for older patients in a Japanese general practice setting enhanced ACP readiness and stimulated discussions, without increasing anxiety. The model discussion video for ACP introduction might effectively train physicians in general practice settings. Geriatr Gerontol Int 2024; 24: 859–866.
The introduction of advance care planning to older patients in a Japanese general practice by physicians trained in a model discussion video based on the Serious Illness Conversation Guide increased advance care planning readiness and stimulated advance care planning discussions without inducing anxiety. |
| doi_str_mv | 10.1111/ggi.14932 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3083219827</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3083219827</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2432-d92029e21f7e2114f95aa66e4df0bfef193348cfa870ac04b10b4ef51bf83f103</originalsourceid><addsrcrecordid>eNp10UFrHCEUB3ApDU2a9tAvUIRe2sMkOro7Y28hpJtAIJfkLI4-dw2OTtXZsP1S_Yo1u2kOhXp4PuTHn4cPoU-UnNF6ztdrd0a5YO0bdEI57xqyEPztvucNXfTLY_Q-50dCaCcofYeOmSCsIz05Qb-vrAVd3BYC5IyjxS644lRxYY2V2aqgAWuVAE9ehbB_HWOt0RtIOM5lqhZCybhsUpzXmxpQINW84mLAww5Pm1122qlQSVIugKkEKzxGAx4bl_Wc87PdOgPxO77ASQUTR_erSh1DSdH72pbklP-AjqzyGT6-3Kfo4cfV_eV1c3u3urm8uG10y1nbGNGSVkBLbVcL5VYslFougRtLBguWCsZ4r63qO6I04QMlAwe7oIPtmaWEnaKvh9wpxZ8z5CLHOij4-gkQ5ywZ6VlLRd92lX75hz7GOYU6nWS0FYJRsuRVfTsonWLOCayckhtV2klK5PMWZd2i3G-x2s8vifMwgnmVf9dWwfkBPDkPu_8nydXq5hD5B7HuqpQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3129931064</pqid></control><display><type>article</type><title>Effectiveness of initiating advance care planning among older outpatients through intervention by physicians trained in a model discussion video: A randomized controlled trial</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Yoshihara‐Kurihara, Hanako ; Hori, Hiroshi ; Fuse, Aya ; Kurihara, Ibuki ; Sueda, Keishiro ; Fukuchi, Takahiko ; Mori, Masanori ; Sugawara, Hitoshi</creator><creatorcontrib>Yoshihara‐Kurihara, Hanako ; Hori, Hiroshi ; Fuse, Aya ; Kurihara, Ibuki ; Sueda, Keishiro ; Fukuchi, Takahiko ; Mori, Masanori ; Sugawara, Hitoshi</creatorcontrib><description>Aim
This study aimed to assess the impact of a physician‐led intervention on advance care planning (ACP) introduction among older outpatients using a model discussion video.
Methods
This prospective interventional study included Japanese general practice outpatients aged ≥65 years. All participants received an ACP leaflet. Co‐researchers were trained using a model discussion video based on the “Serious Illness Conversation Guide,” and provided ACP introduction explanations to the intervention group to ensure intervention content consistency. The control group received the ACP leaflet only, with no standardized explanations. The primary outcome was ACP discussion occurrence. Secondary outcomes included ACP engagement (assessed through the 4‐item ACP Engagement Survey), engagement score for advance directives acquisition and score for surrogate decision‐maker identification, and anxiety incidence (assessed through Generalized Anxiety Disorder‐7).
Results
This study included 48 participants: 25 (52.1%) in the intervention group and 23 (47.9%) in the control group. Regarding primary outcome, the intervention group had significantly more ACP discussions compared with the control group (92.0% vs 26.1%, adjusted odds ratio 50.2, P = 0.0012). Regarding secondary outcomes, the intervention group showed greater readiness (mean scores for the 4‐item Engagement Survey [P = 0.0001], engagement score for advance directives acquisition [P = 0.01] and score for surrogate decision‐maker determination [P = 0.03]) than the control group, without increasing anxiety.
Conclusions
This physician‐led ACP introduction for older patients in a Japanese general practice setting enhanced ACP readiness and stimulated discussions, without increasing anxiety. The model discussion video for ACP introduction might effectively train physicians in general practice settings. Geriatr Gerontol Int 2024; 24: 859–866.
The introduction of advance care planning to older patients in a Japanese general practice by physicians trained in a model discussion video based on the Serious Illness Conversation Guide increased advance care planning readiness and stimulated advance care planning discussions without inducing anxiety.</description><identifier>ISSN: 1444-1586</identifier><identifier>ISSN: 1447-0594</identifier><identifier>EISSN: 1447-0594</identifier><identifier>DOI: 10.1111/ggi.14932</identifier><identifier>PMID: 39037080</identifier><language>eng</language><publisher>Kyoto, Japan: John Wiley & Sons Australia, Ltd</publisher><subject>Advance Care Planning ; Advance directives ; Aged ; Aged, 80 and over ; Anxiety ; Clinical trials ; Female ; general practice setting ; Humans ; Japan ; Male ; model discussion introductory video ; Older people ; Outpatients ; Physician-Patient Relations ; Prospective Studies ; serious illness conversation guide</subject><ispartof>Geriatrics & gerontology international, 2024-09, Vol.24 (9), p.859-866</ispartof><rights>2024 Japan Geriatrics Society.</rights><rights>2024 Japan Geriatrics Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2432-d92029e21f7e2114f95aa66e4df0bfef193348cfa870ac04b10b4ef51bf83f103</cites><orcidid>0000-0002-5060-9020 ; 0000-0001-9466-2125 ; 0009-0004-6339-0779</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fggi.14932$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fggi.14932$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39037080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoshihara‐Kurihara, Hanako</creatorcontrib><creatorcontrib>Hori, Hiroshi</creatorcontrib><creatorcontrib>Fuse, Aya</creatorcontrib><creatorcontrib>Kurihara, Ibuki</creatorcontrib><creatorcontrib>Sueda, Keishiro</creatorcontrib><creatorcontrib>Fukuchi, Takahiko</creatorcontrib><creatorcontrib>Mori, Masanori</creatorcontrib><creatorcontrib>Sugawara, Hitoshi</creatorcontrib><title>Effectiveness of initiating advance care planning among older outpatients through intervention by physicians trained in a model discussion video: A randomized controlled trial</title><title>Geriatrics & gerontology international</title><addtitle>Geriatr Gerontol Int</addtitle><description>Aim
This study aimed to assess the impact of a physician‐led intervention on advance care planning (ACP) introduction among older outpatients using a model discussion video.
Methods
This prospective interventional study included Japanese general practice outpatients aged ≥65 years. All participants received an ACP leaflet. Co‐researchers were trained using a model discussion video based on the “Serious Illness Conversation Guide,” and provided ACP introduction explanations to the intervention group to ensure intervention content consistency. The control group received the ACP leaflet only, with no standardized explanations. The primary outcome was ACP discussion occurrence. Secondary outcomes included ACP engagement (assessed through the 4‐item ACP Engagement Survey), engagement score for advance directives acquisition and score for surrogate decision‐maker identification, and anxiety incidence (assessed through Generalized Anxiety Disorder‐7).
Results
This study included 48 participants: 25 (52.1%) in the intervention group and 23 (47.9%) in the control group. Regarding primary outcome, the intervention group had significantly more ACP discussions compared with the control group (92.0% vs 26.1%, adjusted odds ratio 50.2, P = 0.0012). Regarding secondary outcomes, the intervention group showed greater readiness (mean scores for the 4‐item Engagement Survey [P = 0.0001], engagement score for advance directives acquisition [P = 0.01] and score for surrogate decision‐maker determination [P = 0.03]) than the control group, without increasing anxiety.
Conclusions
This physician‐led ACP introduction for older patients in a Japanese general practice setting enhanced ACP readiness and stimulated discussions, without increasing anxiety. The model discussion video for ACP introduction might effectively train physicians in general practice settings. Geriatr Gerontol Int 2024; 24: 859–866.
The introduction of advance care planning to older patients in a Japanese general practice by physicians trained in a model discussion video based on the Serious Illness Conversation Guide increased advance care planning readiness and stimulated advance care planning discussions without inducing anxiety.</description><subject>Advance Care Planning</subject><subject>Advance directives</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anxiety</subject><subject>Clinical trials</subject><subject>Female</subject><subject>general practice setting</subject><subject>Humans</subject><subject>Japan</subject><subject>Male</subject><subject>model discussion introductory video</subject><subject>Older people</subject><subject>Outpatients</subject><subject>Physician-Patient Relations</subject><subject>Prospective Studies</subject><subject>serious illness conversation guide</subject><issn>1444-1586</issn><issn>1447-0594</issn><issn>1447-0594</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10UFrHCEUB3ApDU2a9tAvUIRe2sMkOro7Y28hpJtAIJfkLI4-dw2OTtXZsP1S_Yo1u2kOhXp4PuTHn4cPoU-UnNF6ztdrd0a5YO0bdEI57xqyEPztvucNXfTLY_Q-50dCaCcofYeOmSCsIz05Qb-vrAVd3BYC5IyjxS644lRxYY2V2aqgAWuVAE9ehbB_HWOt0RtIOM5lqhZCybhsUpzXmxpQINW84mLAww5Pm1122qlQSVIugKkEKzxGAx4bl_Wc87PdOgPxO77ASQUTR_erSh1DSdH72pbklP-AjqzyGT6-3Kfo4cfV_eV1c3u3urm8uG10y1nbGNGSVkBLbVcL5VYslFougRtLBguWCsZ4r63qO6I04QMlAwe7oIPtmaWEnaKvh9wpxZ8z5CLHOij4-gkQ5ywZ6VlLRd92lX75hz7GOYU6nWS0FYJRsuRVfTsonWLOCayckhtV2klK5PMWZd2i3G-x2s8vifMwgnmVf9dWwfkBPDkPu_8nydXq5hD5B7HuqpQ</recordid><startdate>202409</startdate><enddate>202409</enddate><creator>Yoshihara‐Kurihara, Hanako</creator><creator>Hori, Hiroshi</creator><creator>Fuse, Aya</creator><creator>Kurihara, Ibuki</creator><creator>Sueda, Keishiro</creator><creator>Fukuchi, Takahiko</creator><creator>Mori, Masanori</creator><creator>Sugawara, Hitoshi</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5060-9020</orcidid><orcidid>https://orcid.org/0000-0001-9466-2125</orcidid><orcidid>https://orcid.org/0009-0004-6339-0779</orcidid></search><sort><creationdate>202409</creationdate><title>Effectiveness of initiating advance care planning among older outpatients through intervention by physicians trained in a model discussion video: A randomized controlled trial</title><author>Yoshihara‐Kurihara, Hanako ; Hori, Hiroshi ; Fuse, Aya ; Kurihara, Ibuki ; Sueda, Keishiro ; Fukuchi, Takahiko ; Mori, Masanori ; Sugawara, Hitoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2432-d92029e21f7e2114f95aa66e4df0bfef193348cfa870ac04b10b4ef51bf83f103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Advance Care Planning</topic><topic>Advance directives</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anxiety</topic><topic>Clinical trials</topic><topic>Female</topic><topic>general practice setting</topic><topic>Humans</topic><topic>Japan</topic><topic>Male</topic><topic>model discussion introductory video</topic><topic>Older people</topic><topic>Outpatients</topic><topic>Physician-Patient Relations</topic><topic>Prospective Studies</topic><topic>serious illness conversation guide</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshihara‐Kurihara, Hanako</creatorcontrib><creatorcontrib>Hori, Hiroshi</creatorcontrib><creatorcontrib>Fuse, Aya</creatorcontrib><creatorcontrib>Kurihara, Ibuki</creatorcontrib><creatorcontrib>Sueda, Keishiro</creatorcontrib><creatorcontrib>Fukuchi, Takahiko</creatorcontrib><creatorcontrib>Mori, Masanori</creatorcontrib><creatorcontrib>Sugawara, Hitoshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Geriatrics & gerontology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshihara‐Kurihara, Hanako</au><au>Hori, Hiroshi</au><au>Fuse, Aya</au><au>Kurihara, Ibuki</au><au>Sueda, Keishiro</au><au>Fukuchi, Takahiko</au><au>Mori, Masanori</au><au>Sugawara, Hitoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of initiating advance care planning among older outpatients through intervention by physicians trained in a model discussion video: A randomized controlled trial</atitle><jtitle>Geriatrics & gerontology international</jtitle><addtitle>Geriatr Gerontol Int</addtitle><date>2024-09</date><risdate>2024</risdate><volume>24</volume><issue>9</issue><spage>859</spage><epage>866</epage><pages>859-866</pages><issn>1444-1586</issn><issn>1447-0594</issn><eissn>1447-0594</eissn><abstract>Aim
This study aimed to assess the impact of a physician‐led intervention on advance care planning (ACP) introduction among older outpatients using a model discussion video.
Methods
This prospective interventional study included Japanese general practice outpatients aged ≥65 years. All participants received an ACP leaflet. Co‐researchers were trained using a model discussion video based on the “Serious Illness Conversation Guide,” and provided ACP introduction explanations to the intervention group to ensure intervention content consistency. The control group received the ACP leaflet only, with no standardized explanations. The primary outcome was ACP discussion occurrence. Secondary outcomes included ACP engagement (assessed through the 4‐item ACP Engagement Survey), engagement score for advance directives acquisition and score for surrogate decision‐maker identification, and anxiety incidence (assessed through Generalized Anxiety Disorder‐7).
Results
This study included 48 participants: 25 (52.1%) in the intervention group and 23 (47.9%) in the control group. Regarding primary outcome, the intervention group had significantly more ACP discussions compared with the control group (92.0% vs 26.1%, adjusted odds ratio 50.2, P = 0.0012). Regarding secondary outcomes, the intervention group showed greater readiness (mean scores for the 4‐item Engagement Survey [P = 0.0001], engagement score for advance directives acquisition [P = 0.01] and score for surrogate decision‐maker determination [P = 0.03]) than the control group, without increasing anxiety.
Conclusions
This physician‐led ACP introduction for older patients in a Japanese general practice setting enhanced ACP readiness and stimulated discussions, without increasing anxiety. The model discussion video for ACP introduction might effectively train physicians in general practice settings. Geriatr Gerontol Int 2024; 24: 859–866.
The introduction of advance care planning to older patients in a Japanese general practice by physicians trained in a model discussion video based on the Serious Illness Conversation Guide increased advance care planning readiness and stimulated advance care planning discussions without inducing anxiety.</abstract><cop>Kyoto, Japan</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>39037080</pmid><doi>10.1111/ggi.14932</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5060-9020</orcidid><orcidid>https://orcid.org/0000-0001-9466-2125</orcidid><orcidid>https://orcid.org/0009-0004-6339-0779</orcidid></addata></record> |
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| ispartof | Geriatrics & gerontology international, 2024-09, Vol.24 (9), p.859-866 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Advance Care Planning Advance directives Aged Aged, 80 and over Anxiety Clinical trials Female general practice setting Humans Japan Male model discussion introductory video Older people Outpatients Physician-Patient Relations Prospective Studies serious illness conversation guide |
| title | Effectiveness of initiating advance care planning among older outpatients through intervention by physicians trained in a model discussion video: A randomized controlled trial |
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