Trial of Advance Care Planning (ACP) & Goals of Care Designations (GCD) Discussions

Summary

The Canadian population is aging and more people are living with advanced chronic diseases. At the end of life (EOL), the use of invasive medical treatments in hospitals is increasing and associated with worse outcomes. Advance Care Planning (ACP) may help improve care at EOL to be the way patients want it. ACP is a process where people think about the various options related to future health care decisions and they may communicate with a verbal or written plan of what care they would want in the EOL. Also, they may nominate a substitute decision maker if they become unable to speak for themselves. A national poll found that few Canadians have thought about or made an ACP.

Alberta Health Services has developed two videos (Videos) to help with decision making about ACP and goals of care designations(GCD). GCD are medical orders of care that (a) serve as a communication tool for HCP to assist in rapid decision making; and (b) guide HCP and patients regarding the general intent and locations of care, and interventions that are to be provided. This study will compare ACP behaviours and GCD preferences for participants who have seen the Videos with those who have not and measure the change in those behaviours and preferences at 1, 2 and 3 months. It will also look at the impact of the Videos on health care costs and service use. Participants from five patient groups (metastatic lung cancer, colorectal cancer, gynecological cancer, renal failure, and heart failure) were selected as representative of where ACP should ideally be occurring, and where data on ACP implementation is presently most lacking, and as venues in which this research is most feasible. Collecting information about patients' ACP and GCD preferences may help improve AHS decision making tools and more generally help healthcare leaders plan ways to better engage patients in the ACP process.

Conditions

• Advance Care Planning
• Goals of Care

Interventions

OTHER

Conversations Matter videos

2 videos about Advance Care Planning and Goals of Care Designations respectively. These 2 videos were developed by Alberta Health Services and are each 8 minutes long.

Sponsors & Collaborators

• University of Calgary

  collaborator OTHER

• University of Alberta

  lead OTHER

Principal Investigators

• Konrad Fassbender, PhD · University of Alberta

• Sara Davison, MD, MHSc (Bioethics) · University of Alberta

• Jessica Simon, MD · University of Calgary

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

19 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2015-06-30

Primary Completion

2016-11-30

Completion

2016-11-30

Countries

• Canada

Study Locations