Clinical trial NCT06509373: A Portal-based Advance Care Planning Intervention Among Community-Dwelling Persons Living With Cognitive Impairment
Official title: A Portal-based Advance Care Planning Intervention Among Community-Dwelling Persons Living With Cognitive Impairment
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Advanced Care Planning
Keywords: Advance Care Planning
Mild Cognitive Impairment
Dementia
Patient Portal
Lead sponsor: Wake Forest University Health Sciences
Sponsor class: OTHER
Collaborators: name: National Institute on Aging (NIA)
First posted: 2024-07-19
Enrollment: 300
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The purpose of this research is to examine the feasibility of using a patient portal based advance care planning (ACP) tool to improve ACP discussions and documentation in persons living with cognitive impairment in outpatient primary care.

Detailed description: The goal of this study is to explore whether sending a portal-based ACP tool (called ACPVoice) paired with a motivational message within the patient portal before a routine primary care physician visit can improve ACP discussions and documentation within the electronic health record among persons living with cognitive impairment in outpatient primary care.

Eligibility criteria: Inclusion Criteria:

* Age 65 years old and older
* Diagnosis of recognized or probable mild cognitive impairment or mild dementia or elevated eRADAR score
* Completed visit with their primary care provider (PCP) within the past 12 months and have upcoming PCP visit in next 6 months
* Have an active patient portal account

Exclusion Criteria:

* Lives in a long-term care facility
* Severe vision impairment/blindness (as they need to be able to read portal messages)
* Enrolled in hospice
* Lacks decisional capacity as deemed by PCP

Primary outcomes:
measure: Reach/Engagement
timeFrame: 6 months post intervention
measure: Intervention Completion
timeFrame: 6 months post intervention
Secondary outcomes:
measure: Advance Care Planning Documentation Rates by Primary Care Providers
timeFrame: 12 months pre intervention
measure: Advance Care Planning Documentation Rates by Primary Care Providers
timeFrame: 6 months post intervention
measure: Advance Care Planning Billing Code Usage
timeFrame: 12 months pre intervention
measure: Advance Care Planning Billing Code Usage
timeFrame: 6 months post intervention
measure: Documented Designated Surrogate Decision Maker
timeFrame: 12 months pre intervention
measure: Documented Designated Surrogate Decision Maker
timeFrame: 6 months post intervention
Other outcomes:
measure: Barrier to Adoption
timeFrame: 6 months during the implementation period and up to 6 months post the implementation period
measure: Quality of Advance Care Planning Documentation
timeFrame: 6 months during the implementation period and up to 6 months post the implementation period
measure: Participant Confidence related to PCP knowing what is important to them
timeFrame: 6 months during the implementation period and up to 6 months post the implementation period
measure: Feeling Heard and Understood
timeFrame: 6 months during the implementation period and up to 6 months post the implementation period
measure: Digital Health Literacy
timeFrame: 6 months during the implementation period and up to 6 months post the implementation period
measure: Telephone Advance Care Planning Completion Rates
timeFrame: 6 months during the implementation period and up to 6 months post the implementation period
measure: Paper Advance Care Planning Documentation Rates
timeFrame: 6 months during the implementation period and up to 6 months post the implementation period
measure: Preference-concordant care
timeFrame: 6 months during the implementation period and up to 6 months post the implementation period
Locations:
city: Winston-Salem
country: United States
facility: Wake Forest University Health Sciences
state: North Carolina
Study officials:
affiliation: Wake Forest University Health Sciences
name: Jennifer Gabbard, MD
role: PRINCIPAL_INVESTIGATOR
References: