A Community-based Advance Care Planning Programme for Patients With Advanced Disease

Food and Health Bureau, Hong Kong

Status: Completed

Conditions: Chronic Disease

Treatments: Behavioral: Advance care planning programme

Study type: Interventional

Funder types: Other

Identifiers

NCT02068651

11120861

Details and patient eligibility

About

Advance care planning has been recommended as an integral part of care for patients with life-limiting disease, but relevant development in Hong Kong is still in its infancy. This proposed study attempts to address this service gap by promoting advance care planning to patients with advanced disease. It is hypothesized that the proportion of patients whose end-of-life care preferences were known in the experimental group will be significantly higher than that in the control group.

Full description

This study aims to evaluate the impacts of a community-based advance care planning programme on end-of-life care of patients with advanced disease. A mixed-method approach, including a randomized controlled trial and qualitative interviews, will be used. Participants in the experimental group will received a structured advance care planning programme delivered by a trained facilitator. It includes an educational component, reflection and a family meeting.

Enrollment: 239 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• aged 18 or above
• meet one of the three triggers for supportive /palliative care as suggested in the Gold Standards Framework
• living at home
• being communicable

Exclusion criteria

• mentally incompetent
• cannot nominate a family carer
• have already signed an advance directive
• have been referred to palliative care service

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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239 participants in 2 patient groups

Advance care planning programme

Experimental group

Description:

Participants in the experimental group will receive a structured advance care planning programme, namely Let Me Talk, delivered by a trained nurse facilitator. The programme will be conducted on individual basis through three one-hour home visits, once weekly. Family carers of the participants will be invited to all sessions.

Treatment:

Behavioral: Advance care planning programme

Usual care

No Intervention group

Description:

Participants in the control group will receive three weekly home visits with basic health assessment and education provided by the trained nurse facilitator. If they request advance care planning information or assistance, an advance directive form, which is available on the Internet for public access, will be provided to them for their information.