ENgaging in Advance Care Planning Talks Group Visit Intervention (ENACT)

University of Colorado Denver (CU Denver)

Status: Completed

Conditions: Advance Care Planning; Primary Health Care

Treatments: Behavioral: ENACT group visit; Behavioral: Mailed Resources

Study type: Interventional

Funder types: Other

Identifiers

NCT03141242

16-1922

Details and patient eligibility

About

The main goal of the ENACT (ENgaging in Advance Care planning Talks) Group Visit intervention is to integrate a patient-centered advance care planning process into primary care, ultimately helping patients to receive medical care that is aligned with their values. The ENACT Group Visit intervention involves two group discussions about advance care planning with 8-10 patients who meet for 2-hour sessions, one month apart, facilitated by a geriatrician and a social worker. This study will compare the ENACT Group Visit intervention to mailed advance care planning materials.

Full description

This pilot feasibility randomized controlled study will determine the feasibility, acceptability and preliminary efficacy of the ENACT Group Visit intervention compared to a comparison arm.

The ENACT Group Visit intervention aims to engage patients in an interactive discussion of key ACP concepts and support patient-initiated ACP actions (i.e. choosing decision-maker(s), deciding on preferences during serious illness, discussing preferences with decision-makers and healthcare providers, and documenting advance directives). The group visits involve two 2-hour sessions, one month apart, facilitated by a geriatrician and a social worker. The ENACT Group Visit is based on an intervention manual that guides the structure, facilitator considerations, session format, and documentation and billing details. The discussions include sharing experiences related to ACP, considering values related to serious illness, choosing a surrogate decision-maker(s), flexibility in decision making, and having conversations with decision-makers and healthcare providers. The facilitators support an interactive discussion that promotes opportunities for patients to learn from others' experiences.

Enrollment: 110 patients

Sex: All

Ages: 50+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 50 or older
• Receive primary care through UCHealth, Colorado, USA.

Exclusion criteria

• Severe cognitive impairment, known diagnoses of dementia
• Severe hearing loss or deafness

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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110 participants in 2 patient groups, including a placebo group

ENACT Group Visit

Active Comparator group

Description:

Participants will engage in two 2-hour group visits related to advance care planning, including printed advance care planning resources.

Treatment:

Behavioral: ENACT group visit

Mailed Resources

Placebo Comparator group

Description:

Participants will receive printed advance care planning resources by mail.

Treatment:

Behavioral: Mailed Resources