Decision Support on End-of-life Care Planning in Older Adults

Summary

This study aims to test the effects of a patient decision aid (PDA) on planning for end-of-life (EOL) care among older adults with COPD. The main questions it aims to answer are:

1. Does a PDA improve the process of a person to make decisions on EOL care?
2. Does a PDA improve the readiness of a person to join advance care planning (ACP) communication?
3. Does a person make an advance directive after using a PDA?

Participants in this study will:

1. Be randomly assigned to one of two groups.
2. In the experimental group, participants will receive two 60-minute interactive consultations over four weeks, using a PDA to help clarify values and preferences for future medical care. A guidebook summarising these future care options will be provided.
3. In the control group, participants will receive two 60-minute sessions on lifestyle modification and self-care management over four weeks using a guidebook with coaching. A guidebook summarising general health information will be provided.

Researchers will compare the intervention group to the control group to see if the PDA is better at improving the decision-making process on EOL care, the readiness of a person to join ACP communication and the chance to make an advance directive.

Conditions

• Chronic Obstructive Pulmonary Disease

Interventions

OTHER

COPD Patient Decision Aid

Participants in this group will receive two 60-minute intervention sessions in one month. The COPD PDA consists of three main parts: The first component, clinical counselling, guides the participants in reviewing the common EOL scenarios. The second component, an evidence-based decision aid, is presented as an option grid in a booklet and a video to provide information about outcome probabilities of various treatment options and survival estimates in a balanced and unbiased manner. The information is presented in plain language for laypersons. The third component, decision coaching, introduces the concept of ACP and guides deliberation through value clarification.

OTHER

General Health Coaching Intervention

The participants in the control group will receive two 60-minute health coaching sessions developed by the PI for another project as an attention placebo control. Trained research personnel will use the same amount of interaction time and similar formats to avoid threats to the study's internal validity. This intervention will focus on lifestyle modification and self-care management unrelated to the tested intervention content or outcomes. The trained research personnel will give the guidebook consisting of general self-management advice to participants in this group.

Sponsors & Collaborators

• Chinese University of Hong Kong

  collaborator OTHER

• National Taipei University of Nursing and Health Sciences

  lead OTHER

Principal Investigators

• Jenny Lai, DN · National Taipei University of Nursing and Health Sciences

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-03-10

Primary Completion

2024-12-31

Completion

2025-01-31