Clinical trial NCT04931797: Video Images About Decisions for Ethical Outcomes in the Emergency Department (VIDEO-ED)
Official title: Using the Emergency Department Visit to Promote Advance Care Planning
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Emergencies
Lead sponsor: Massachusetts General Hospital
Sponsor class: OTHER
Collaborators: name: University of California, Davis
name: National Institute on Aging (NIA)
First posted: 2021-06-18
Enrollment: 900
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: RCT
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: A randomized controlled trial of a video decision aid in the Emergency Department Setting to improve advance care planning documentation.

Detailed description: A randomized controlled trial of a video decision aid in the Emergency Department setting shown to patients followed by a brief advance care planning discussion and then relay that discussion to the patient's primary care provider and/or admitting clinical team and look at rates of advance care planning documentation in the electronic health record over time. Primary outcome is advance care planning documentation in the EHR at 3 months.

Eligibility criteria: Inclusion Criteria:

* anyone aged 65 and over or anyone aged over 50-64 with an indicator of serious illness

Exclusion Criteria:

* non english or spanish speakers those with a POLST legally blind medically non stable requiring ICU level care

Primary outcomes:
measure: EHR documentation of advance care planning
timeFrame: 3 months
Secondary outcomes:
measure: patient reported conversations with health care providers and family
timeFrame: at 3 and 6 months
measure: concordance between stated and documented preferences
timeFrame: at 3 and 6 months
measure: ACP documentation in the EHR
timeFrame: at 6 months
measure: hospitalization
timeFrame: at 3 and 6 months
measure: differential intervention effects of the ACP video intervention on patient ACP documentation based on race and ethnicity
timeFrame: at baseline, 3 and 6 months
measure: quality of clinician ACP communication using an ACP quality communication survey
timeFrame: quality of communication at the time of the survey interview (baseline), and then at 3 and 6 months
measure: place of death
timeFrame: at 3 and 6 months
measure: enrollment in hospice
timeFrame: at 3 and 6 months
measure: ED visits
timeFrame: at 3 and 6 months
measure: mortality
timeFrame: at 3 and 6 months
measure: ICU days
timeFrame: at 3 and 6 months
measure: patient CPR and breathing machine preferences
timeFrame: at time of survey (baseline) and then after 3 and 6 months
measure: patient preferences for goals of care
timeFrame: at time of survey (baseline) and then after 3 and 6 months
measure: decisional certainty regarding decision making for ACP preferences
timeFrame: at baseline survey interview
measure: patient knowledge of ACP
timeFrame: at baseline survey interview
measure: patient confidence in health care delivery that is aligned with patient preferences
timeFrame: at time of survey (baseline) and then after 3 and 6 months
measure: patient ACP engagement with ACP topics
timeFrame: at baseline survey interview
Other outcomes:
Locations:
city: Davis
country: United States
facility: UC Davis
state: California
city: Boston
country: United States
facility: Massachusetts General Hospital
state: Massachusetts
city: Boston
country: United States
facility: Brigham and Women's Hospital
state: Massachusetts
city: Newton
country: United States
facility: Newton Wellesley Hospital
state: Massachusetts
Study officials:
References: