Clinical trial NCT02289105: Impact of Active Choice on Advance Directive Completion Rates
Official title: The Impact of Active Choice on Completion Rates of Advanced Directives in New Employees of an Academic University Hospital
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Advance Directive Completion
Keywords: Advance Directive
Active Choice
Decision making
Lead sponsor: University of Pennsylvania
Sponsor class: OTHER
First posted: 2014-11-13
Enrollment: 1279
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The overall objective of this project is to assess if an active choice intervention can increase advance directive completion rates.

Detailed description: Nearly 70% of Americans express the desire to die at home, and most individuals want to avoid aggressive or futile care. Despite this, more than half of Americans die in a hospital. Advance directives provide the opportunity to provide, in advance, one's wishes for end of life care, however their completion rates are low. The overall objective of this project is to assess if an active choice intervention can increase AD completion rates. Eligible participants for this study will be all new employees of the University of Pennsylvania Health System (UPHS) who need to complete their online employment paperwork via the On Boarding portal. Participants will have an advanced health care planning task programmed as part of their On Boarding online employment paperwork. Upon selection of the task, each participant will be directed a designated Advance Healthcare Planning (AHCP) website. Participants will be randomized into either the active choice or control arm of the study and proceed through steps to complete or not complete an AD according to the decision making process of the given study arm. All participants in both groups will have access to additional online and telephone resources thought the entire study for any questions. Participants in the active choice group will be given directions stating they are required to complete either the advanced directive or the declination form in order to complete their On Boarding process. Participants in the control group will be given directions stating that completion of the AD is optional.

Eligibility criteria: Inclusion Criteria:

* New participants of the University of Pennsylvania Health System who have not yet completed their On Boarding process.
* 18 years of age or older
* Have proficiency in reading, writing, and speaking English

Exclusion Criteria:

* All new UPHS employees will be enrolled

Primary outcomes:
measure: Proportion of Participants That Select to Complete an Advance Directive
timeFrame: Baseline - up to 1 year
Secondary outcomes:
measure: Proportion of Participants Who Already Have ADs
timeFrame: Baseline - up to 1 year
measure: Proportion of Participants Who Return a Signed AD
timeFrame: Baseline - up to 1 year
Other outcomes:
measure: Participant Selections on ADs and Declination Forms
timeFrame: Baseline - up to 1 year
Locations:
city: Philadelphia
country: United States
facility: University of Pennsylvania
state: Pennsylvania
Study officials:
affiliation: University of Pennsylvania
name: Scott D Halpern, MD, PhD,
role: PRINCIPAL_INVESTIGATOR
References: