Encouraging Older Adults and Adults With Serious Illness to Designate a Health Care Proxy

University of Southern California

Status: Begins enrollment this month

Conditions: Designating a Healthcare Proxy

Treatments: Behavioral: Personalized Provider Request; Behavioral: Mailer; Behavioral: Pre-commitment Prompt

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT07290478

UP-23-01203

P30AG024968 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This study is a Stage III randomized trial to encourage patients in advance of a health care appointment to designate a healthcare proxy. Patients will be randomly assigned to receive a mailer containing information about designating a healthcare proxy, or to not receive any mailer. For patients assigned to receive a mailer, the mailer will differ by the presence or absence of a patient pre-commitment prompt, and contain a personalized provider request or a generic health system request. The work will evaluate the randomized trial and identify factors that predict intervention effectiveness.

Enrollment: 10,000 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• No EHR-documented healthcare proxy at enrollment
• Age ≥ 55 years OR age ≥ 18 years and listed in the health system's cancer, CHF, or CKD registries

Exclusion criteria

• None

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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10,000 participants in 5 patient groups

Personalized Provider Mailer with a Pre-commitment Prompt

Experimental group

Description:

Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by their primary care provider.

Treatment:

Behavioral: Pre-commitment Prompt

Behavioral: Personalized Provider Request

Behavioral: Mailer

Generic Health System Mailer with a Pre-commitment Prompt

Experimental group

Description:

Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system

Treatment:

Behavioral: Pre-commitment Prompt

Behavioral: Mailer

Personalized Provider Mailer without a Pre-commitment Prompt

Experimental group

Description:

Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the patient's provider.

Treatment:

Behavioral: Personalized Provider Request

Behavioral: Mailer

Generic Health System Mailer without a Pre-commitment Prompt

Experimental group

Description:

Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system.

Treatment:

Behavioral: Mailer

No Mailer Control

No Intervention group

Description:

Patients will not receive a mailer.