Sharing Health Care Wishes in Primary Care (SHARE) among older adults with possible cognitive impairment in primary care: Study protocol for a randomized controlled trial.

Humans Aged Terminal Care Advance Care Planning Delivery of Health Care Primary Health Care Cognitive Dysfunction / therapy Randomized Controlled Trials as Topic
Advance care planning Cognitive impairment Primary care Randomized controlled trial

Journal

Contemporary clinical trials
ISSN: 1559-2030
Titre abrégé: Contemp Clin Trials
Pays: United States
ID NLM: 101242342

Informations de publication

Date de publication:
06 2023
Historique:
received: 19 12 2022
revised: 19 04 2023
accepted: 23 04 2023
pmc-release: 01 06 2024
medline: 29 5 2023
pubmed: 29 4 2023
entrez: 28 4 2023
Statut: ppublish

Résumé

Little is known about effective strategies to improve advance care planning (ACP) for persons with cognitive impairment in primary care, the most common setting of care. We describe a randomized controlled trial to test the efficacy of a multicomponent communication intervention, "Sharing Healthcare Wishes in Primary Care" (SHARE). Planned enrollment of 248 dyads of adults 80 years and older with possible cognitive impairment and their care partner, from primary care clinics at 2 Mid-Atlantic health systems. The treatment protocol encompasses an introductory letter from the clinic; access to a designated facilitator trained in ACP; person-family agenda-setting to align perspectives about the family's role; and print education. The control protocol encompasses minimally enhanced usual care, which includes print education and a blank advance directive. Randomization occurs at the individual dyad-level. Patient and care partner surveys are fielded at baseline, 6-, 12-, and 24- months. Fidelity of interventionist delivery of the protocol is measured through audio-recordings of ACP conversations and post-meeting reports, and by ongoing monitoring and support of interventionists. The primary outcome is quality of end-of-life care communication at 6 months; secondary outcomes include ACP process measures. An exploratory aim examines end-of-life care quality and bereaved care partner experiences for patients who die by 24 months. Caregiver burden, clinician barriers, and impaired decisional capacity amplify the difficulty and importance of ACP discussions in the context of cognitive impairment: this intervention will comprehensively examine communication processes for this special subpopulation in a key setting of primary care. ClinicalTrials.gov: NCT04593472.

Identifiants

DOI: 10.1016/j.cct.2023.107208 PMID: 37116645 PMC: PMC10258688
pubmed: 37116645
pii: S1551-7144(23)00131-3
doi: 10.1016/j.cct.2023.107208
pmc: PMC10258688
mid: NIHMS1900409
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04593472']

Types de publication

Clinical Trial Protocol Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

107208

Subventions

Organisme : NIA NIH HHS
ID : R01 AG058671
Pays : United States
Organisme : NIA NIH HHS
ID : T32 AG066576
Pays : United States

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they do not have any competing interests to report.

Références

Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
AIDS. 1999 Jun 18;13(9):1123-31
pubmed: 10397544
Am J Hosp Palliat Care. 2021 Nov;38(11):1314-1321
pubmed: 33325729
Alzheimer Dis Assoc Disord. 2009 Oct-Dec;23(4):306-14
pubmed: 19568149
Chest. 2012 Mar;141(3):726-735
pubmed: 21940765
Aging Ment Health. 2011 Nov;15(8):978-84
pubmed: 21777080
Med Care. 2012 Mar;50(3):217-26
pubmed: 22310560
J Clin Oncol. 2012 Dec 10;30(35):4387-95
pubmed: 23150700
Palliat Med. 2007 Sep;21(6):507-17
pubmed: 17846091
J Pain Symptom Manage. 2017 Sep;54(3):383-386
pubmed: 28797865
J Am Geriatr Soc. 2023 Jan;71(1):221-226
pubmed: 36069000
Am J Public Health. 2003 Aug;93(8):1261-7
pubmed: 12893608
Int J Geriatr Psychiatry. 2003 Apr;18(4):318-24
pubmed: 12673608
Gerontologist. 2016 Jun;56(3):525-34
pubmed: 25326342
Med Decis Making. 1995 Jan-Mar;15(1):25-30
pubmed: 7898294
J Am Med Dir Assoc. 2016 Sep 1;17(9):802-6
pubmed: 27297089
J Am Geriatr Soc. 2016 Jun;64(6):1299-306
pubmed: 27321609
J Pain Symptom Manage. 2017 Apr;53(4):669-681.e8
pubmed: 28042072
Ann Intern Med. 2011 Mar 1;154(5):336-46
pubmed: 21357911
Health Aff (Millwood). 2014 Apr;33(4):667-74
pubmed: 24711329
J Am Med Inform Assoc. 2017 Apr 1;24(e1):e166-e172
pubmed: 27497795
JAMA. 2016 May 17;315(19):2086-94
pubmed: 27187301
J Palliat Med. 2017 Sep;20(9):939-945
pubmed: 28375815
N Engl J Med. 2013 Apr 4;368(14):1326-34
pubmed: 23550670
NPJ Breast Cancer. 2021 Feb 12;7(1):14
pubmed: 33579966
BMJ Support Palliat Care. 2019 Dec;9(4):397-403
pubmed: 31537578
JAMA Intern Med. 2016 Dec 1;176(12):1872-1875
pubmed: 27802496
J Pain Symptom Manage. 2017 May;53(5):821-832.e1
pubmed: 28062339
Soc Sci Med. 2011 Mar;72(6):823-31
pubmed: 21353358
Prim Care Companion CNS Disord. 2013;15(4):
pubmed: 24392252
J Clin Epidemiol. 1992 Sep;45(9):941-50
pubmed: 1432023
J Palliat Med. 2006 Oct;9(5):1086-98
pubmed: 17040146
Stat Methods Med Res. 2010 Aug;19(4):349-77
pubmed: 20442193
J Am Geriatr Soc. 2018 Aug;66(8):1469-1474
pubmed: 30277566
BMJ. 2010 Mar 23;340:c1345
pubmed: 20332506
J Psychiatr Res. 2011 May;45(5):626-9
pubmed: 21035130
J Gen Intern Med. 2018 Sep;33(9):1478-1486
pubmed: 30022409
J Pain Symptom Manage. 2019 May;57(5):980-988.e9
pubmed: 30684633
Neuroepidemiology. 2010;34(1):34-42
pubmed: 19893327
JAMA Oncol. 2017 Jan 01;3(1):92-100
pubmed: 27612178
Arch Intern Med. 1998 Feb 23;158(4):383-90
pubmed: 9487236
JAMA Intern Med. 2016 Sep 1;176(9):1380-7
pubmed: 27398990
Clin Psychol Sci. 2014 Jan 1;2(1):22-34
pubmed: 25821658
N Engl J Med. 2010 Apr 1;362(13):1211-8
pubmed: 20357283
J Am Geriatr Soc. 2014 Feb;62(2):312-9
pubmed: 24417565
J Pain Symptom Manage. 2014 Apr;47(4):674-86
pubmed: 23972574
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):751-7
pubmed: 24503882
BMC Cancer. 2013 Apr 09;13:188
pubmed: 23570278
JAMA Intern Med. 2017 Aug 1;177(8):1102-1109
pubmed: 28520838
Ann Am Thorac Soc. 2018 Sep;15(9):1083-1091
pubmed: 30088971
JAMA. 2011 Oct 5;306(13):1447-53
pubmed: 21972306
PLoS One. 2013 Sep 05;8(9):e72465
pubmed: 24039772
Med Care. 2002 Sep;40(9):771-81
pubmed: 12218768
Alzheimer Dis Assoc Disord. 2001 Oct-Dec;15(4):194-200
pubmed: 11723370
J Am Med Inform Assoc. 2016 Nov;23(6):1150-1158
pubmed: 27026614
JAMA Intern Med. 2017 Jan 1;177(1):24-31
pubmed: 27893884
J Am Geriatr Soc. 2004 Jul;52(7):1051-9
pubmed: 15209641
Arch Gerontol Geriatr. 2011 Jan-Feb;52(1):e26-30
pubmed: 20471701
Health Psychol. 2004 Sep;23(5):443-51
pubmed: 15367063
JAMA Otolaryngol Head Neck Surg. 2020 Feb 1;146(2):101-102
pubmed: 31804662
Patient Educ Couns. 2015 Jul;98(7):822-9
pubmed: 25892504
JAMA. 2008 Oct 8;300(14):1665-73
pubmed: 18840840
Acta Oncol. 2010;49(2):136-43
pubmed: 20100151

Auteurs

Jennifer L Wolff (JL)

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America. Electronic address: jwolff2@jhu.edu.

John Cagle (J)

School of Social Work, University of Maryland, Baltimore, Baltimore, MD, United States of America. Electronic address: jcagle@ssw.umaryland.edu.

Diane Echavarria (D)

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States of America. Electronic address: dechava1@jhu.edu.

Sydney M Dy (SM)

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States of America. Electronic address: dy1@jhu.edu.

Erin R Giovannetti (ER)

Health Economics and Aging Research Institute, MedStar Health, 10980 Grantchester Way Columbia, MD 21044, United States of America. Electronic address: Erin.giovannetti@medstar.net.

Cynthia M Boyd (CM)

Division of Geriatric Medicine & Gerontology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building, Center Tower, Room 317, Baltimore, MD 21224, United States of America. Electronic address: cyboyd@jhmi.edu.

Valecia Hanna (V)

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States of America. Electronic address: Vhanna1@jhu.edu.

Naaz Hussain (N)

Johns Hopkins Community Physicians, 45 TJ Drive, Suite 109, Frederick, MD 21702, United States of America. Electronic address: nhussai1@jhmi.edu.

Jenni S Reiff (JS)

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America. Electronic address: jreiff3@jhu.edu.

Danny Scerpella (D)

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States of America. Electronic address: dscerpe1@jhu.edu.

Talan Zhang (T)

Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD, United States of America. Electronic address: tzhang45@jhu.edu.

David L Roth (DL)

Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD, United States of America. Electronic address: droth@jhu.edu.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Sharing Health Care Wishes in Primary Care...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sharing Health Care Wishes in Primary Care...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Soins terminaux › Sharing Health Care Wishes in Primary Care...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Planification des soins du patient › Planification anticipée des soins › Sharing Health Care Wishes in Primary Care...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Sharing Health Care Wishes in Primary Care...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Sharing Health Care Wishes in Primary Care...
questionsmedicales.fr › Troubles mentaux › Troubles neurocognitifs › Troubles de la cognition › Dysfonctionnement cognitif › Sharing Health Care Wishes in Primary Care...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › Sharing Health Care Wishes in Primary Care...