Clinical trial NCT01914848: Multiprofessional Advance Care Planning and Shared Decision Making for End of Life Care
Official title: Multiprofessional Advance Care Planning and Shared Decision-making for End of Life Care MAPS Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Palliative Patients
Surrogate Decision Maker
Lead sponsor: University of Zurich
Sponsor class: OTHER
First posted: 2013-08-02
Enrollment: 115
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Multiprofessional Advance Care Planning and shared decision making for end of live care for terminal patients and their relatives.

The aim of this study is to develop, implement and test a complex intervention for improving patients' preparation for and participation in end of life decisions. In cooperation with local, national and international partners, the investigators will focus on strategies to enhance advance care planning and shared decision making on end of life issues, and documentation and transferability of end of life decisions across health care settings in coordinated approach involving patients, their families and care givers (in and out of hospital).


Eligibility criteria: Inclusion criteria: -patients in which the treating physician on the ward would not be surprised if the patient died during the next year (surprise question of Weissman et al 2011)

* male and female patients above 18 years of age
* signed informed consent after being informed
* patients able to appoint a surrogate decision maker (SM) and/or responsible physician to be contacted after discharge

Exclusion criteria: -patients not capable of speaking german

* patients having no responsible physician to be contacted after discharge and no relative/future surrogate decision maker (SM)
* inhouse patients being discharged within the next 2 days or ambulatory patients not regularly coming to the wards (at least every two month)
* patients assessed by their physician to be in obvious denial of their situation (illness/prognosis)

Primary outcomes:
measure: end of life wish on resuscitation known (if alive) or fulfilled(if dead) after 6 month by responsible physician and/or surrogate decision maker (SM)
timeFrame: during 2 weeks six months after discharge
Secondary outcomes:
measure: end of live decisions on last place of care, antibiotics for pneumonia, feeding tube, intravenous fluids, dialysis, intubation and sedation,
timeFrame: during 2 weeks six months after discharge
measure: decisional conflict scale ("DCS"), O Connor et al 1995
timeFrame: at discharge and during 2 Weeks six months after discharge
measure: Satisfaction with information and care, (see Detering et al 2010)
timeFrame: at discharge
measure: Hospital Anxiety and Depression scale ("HADS")
timeFrame: discharge and during 2 weeks six months after discharge
measure: Having an Advance directive
timeFrame: at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge
measure: Having an appointed surrogate decision maker
timeFrame: at discharge, during 2 weeks three month after discharge and during 2 weeks six month after discharge
measure: Any hospital stay
timeFrame: during 2 weeks three months after discharge and during 2 weeks six months after discharge
measure: Decisions regarding end of life issues already having been made/taken place
timeFrame: during 2 weeks six months after discharge
measure: open question on important medical decisions being made
timeFrame: during 2 weeks three months after discharge
measure: Treatment against patients wishes
timeFrame: during 2 weeks three months after discharge and during 2 weeks six months after discharge, or 3 month after death
measure: Distress of Patients or relatives because of content of the consultation
timeFrame: at discharge, during 2 weeks three months after discharge and during 2 weeks six months after discharge
Other outcomes:
Locations:
city: Zurich
country: Switzerland
facility: University Hospital Zurich, Clinical Ethics
state: ZH
Study officials:
affiliation: University Hospital Zurich, Clinical Ethics
name: Tanja Krones, MD
role: PRINCIPAL_INVESTIGATOR
References: