Pragmatic Trial of Video Education in Nursing Homes

Summary

This is a pragmatic cluster-randomized control trial (RCT) of an Advance Care Planning (ACP) Video Program for nursing home (NH) patients ≥ 65 years old who are cared for in 360 NH facilities (intervention arm n=119; control arm n=241) within two NH health care systems: Genesis HealthCare and PruittHealth. The intervention NH facilities will implement the ACP Video Program, while the control NH facilities will follow their usual ACP procedures. The trial will evaluate the effectiveness of the ACP Video Program by comparing hospitalizations, advance directives, and hospice use in the intervention vs. control NHs.

Conditions

• Alzheimer Disease
• Dementia
• Heart Failure
• Pulmonary Disease, Chronic Obstructive

Interventions

BEHAVIORAL

ACP Video Program

The ACP Video Program consists of five videos that address ACP decisions: (1) General Goals of Care, (2) Goals of Care for Advanced Dementia, (3) Hospice, (4) Hospitalization, and (5) ACP for Healthy Patients. NH staff will offer videos to patients at these clinical triggers: (1) Within 7 days of admission or readmission; (2) Every 6 months for long-stay patients; (3) When there is a significant change in clinical status; (4) When a treatment decision arises for which there is a specific video; and (5) Special circumstances when goals of care are being considered (e.g., family visiting).

Sponsors & Collaborators

• National Institute on Aging (NIA)

  collaborator NIH

• Hebrew SeniorLife

  collaborator OTHER

• Massachusetts General Hospital

  collaborator OTHER

• Genesis HealthCare

  collaborator OTHER

• PruittHealth

  collaborator OTHER

• Brown University

  lead OTHER

Principal Investigators

• Vincent Mor, PhD · Brown University

• Susan Mitchell, MD, MPH · Hebrew SeniorLife

• Angelo Volandes, MD, MPH · Massachusetts General Hospital

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2016-03-01

Primary Completion

2019-05-31

Completion

2019-05-31

Countries

• United States

Study Locations