Preparing Older Adults with Serious Illness To Formulate Their Goals for Medical Care in the Emergency Department

Ouchi, Kei; Knabben, Vinicius; Rivera-Reyes, Laura; Ganta, Niharika; Gelfman, Laura P.; Sudore, Rebecca L.; Hwang, Ula

doi:10.1089/jpm.2016.0109

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Table 2 presents an overview of the content of the Web-based ACP programs, and Multimedia Appendix 2 presents the links to the Web-based programs. Target groups, for example, patients, were involved in the development of seven programs [31,[34][35][36][37][38][39][40][41][42][43][44][45]47,[49][50][51][52][53][54][55][56][57]. Four programs had a theory base [34][35][36][37][38][39][40][41][42][43][44][45]47,50,57], for example, Making Your Wishes Known was based on the Multi-Attribute Utility Theory, and PREPARE was based on behavior change theories.…”

Section: Content Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

“…Most programs were evaluated in one study [31][32][33][47][48][49]56,57], two studies evaluated MyDirectives [38,46], seven studies evaluated PREPARE [38,[50][51][52][53][54][55], and 12 studies evaluated Making Your Wishes Known in [34][35][36][37][38][39][40][41][42][43][44][45]. Multimedia Appendix 3 presents an overview of the characteristics of the studies.…”

Section: Evaluation Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

“…All studies were published in the period from 2007 to 2018, of which nine studies were published in 2017. In total, 25 of the studies have a quantitative design [31,[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][51][52][53][54][55][56][57], and two study designs are qualitative [32,50]. Nine studies allowed comparison of outcomes before/after an intervention [31,35,40,42,43,45,[53][54][55], and eight studies allowed comparison between intervention and control groups [31,39,45,49,52,[54][55][56].…”

Section: Evaluation Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

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The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review

et al. 2020

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Background Advance care planning (ACP) is a process with the overall aim to enhance care in concordance with patients’ preferences. Key elements of ACP are to enable persons to define goals and preferences for future medical treatment and care, to discuss these with family and health care professionals, and to document and review these if appropriate. ACP is usually conducted through personal conversations between a health care professional, a patient, and—if appropriate—family members. Although Web-based ACP programs have the potential to support patients in ACP, their effectiveness is unknown. Objective This study aimed to assess the feasibility and effectiveness of Web-based, interactive, and person-centered ACP programs. Methods We systematically searched for quantitative and qualitative studies evaluating Web-based, interactive, and person-centered ACP programs in seven databases including EMBASE, Web of Science, Cochrane Central and Google Scholar. Data on the characteristics of the ACP programs’ content (using a predefined list of 10 key elements of ACP), feasibility, and effectiveness were extracted using a predesigned form. Results Of 3434 titles and abstracts, 27 studies met the inclusion criteria, evaluating 11 Web-based ACP programs—10 were developed in the United States and one in Ireland. Studied populations ranged from healthy adults to patients with serious conditions. Programs typically contained the exploration of goals and values (8 programs), exploration of preferences for treatment and care (11 programs), guidance for communication about these preferences with health care professionals or relatives (10 programs), and the possibility to generate a document in which preferences can be recorded (8 programs). Reportedly, participants were satisfied with the ACP programs (11/11 studies), considering them as easy to use (8/8 studies) and not burdensome (7/8 studies). Designs of 13 studies allowed evaluating the effectiveness of five programs. They showed that ACP programs significantly increased ACP knowledge (8/8 studies), improved communication between patients and their relatives or health care professionals (6/6 studies), increased ACP documentation (6/6 studies), and improved concordance between care as preferred by the patients and the decisions of clinicians and health care representatives (2/3 studies). Conclusions Web-based, interactive, and person-centered ACP programs were mainly developed and evaluated in the United States. They contained the key elements of ACP, such as discussing and documenting goals and preferences for future care. As participants considered programs as easy to use and not burdensome, they appeared to be feasible. Among the 13 studies that measured the effectiveness of programs, improvement in ACP knowledge, communication, and documentation was reported. The concordance between preferred and received care is yet understudied. Studies with high-quality study designs in different health care settings are warranted to further establish the feasibility and effectiveness of Web-based ACP programs.

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Section: Content Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

Section: Evaluation Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

Section: Evaluation Of the Web-based Advance Care Planning Programsmentioning

confidence: 99%

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The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review

et al. 2020

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“…Among the frequently studied models of care delivery was primary PC or the training and education of ED clinicians in targeted PC skills 71–75 . The literature on model development also focused heavily on specific tools for communication, screening, and consults 7,19,76–81 …”

Section: Resultsmentioning

confidence: 99%

“…[71][72][73][74][75] The literature on model development also focused heavily on specific tools for communication, screening, and consults. 7,19,[76][77][78][79][80][81] In facilitated discussion related to gaps, several clear gaps were identified and consensus reached related to the most pressing areas for future research focus. The first related to understanding the value imperative for PC in EM, with a focus on expanding on the limited literature currently available on the perspectives of patients, are and what value they derive from the programs and services that are being designed and tested.…”

Section: Gaps In the Literature To Datementioning

confidence: 99%

Mapping the future for research in emergency medicine palliative care: A research roadmap

Aaronson

Wright

Ritchie

et al. 2022

Academic Emergency Medicine

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Background The intersection of emergency medicine (EM) and palliative care (PC) has been recognized as an essential area of focus, with evidence suggesting that increased integration improves outcomes. This has resulted in increased research in EM PC. No current framework exists to help guide investigation and innovation. Objective The objective was to convene a working group to develop a roadmap that would help provide focus and prioritization for future research. Methods Participants were identified based on clinical, operation, policy, and research expertise in both EM and PC and spanned physician, nursing, social work, and patient perspectives. The research roadmap setting process consisted of three distinct phases that were time staggered over 12 months and facilitated through three live video convenings, asynchronous input via an online document, and a series of smaller video convenings of work groups focused on specific topics. Results Gaps in the literature were identified and informed the four key areas for future research. Consensus was reached on these domains and the associated research questions in each domain to help guide future study. The key domains included work focused on the value imperative for PC in the emergency setting, models of care delivery, disparities, and measurement of impact and efficacy. Additionally, the group identified key methodological considerations for doing work at the intersection of EM and PC. Conclusions There are several key domains and associated questions that can help guide future research in ED PC. Focus on these areas, and answering these questions, offers the potential to improve the emergency care of patients with PC needs.

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Health Services Research

Dinan¹,

Check²

2022

Holland‐Frei Cancer Medicine

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Overview Health services research (HSR) describes a diverse group of research strategies and fields that seek to evaluate the impact of health care on patients and populations and has been a critical component of understanding the use, outcomes, and costs associated with oncology care since its inception over 100 years ago. In modern times, physicians and researchers often tout “bench to bedside” innovations as the goal of biomedical research. However, patients, physicians, and health care systems in the real world are subjected to a host of factors that impact patient care before, during, and after an intervention occurs at the bedside. Although HSR is a complex and evolving concept, a basic understanding of the key principles of HSR is needed to accurately assess, quantify, and optimize the real‐world impact of progress in oncology today and in the future.

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Preparing Older Adults with Serious Illness To Formulate Their Goals for Medical Care in the Emergency Department

Abstract: PREPARE has the potential to engage older adults who are not acutely ill in ACP during their ED visits. Further studies should explore optimal approaches for ED implementation.

Cited by 8 publications

References 25 publications

The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review

The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review

Mapping the future for research in emergency medicine palliative care: A research roadmap

Health Services Research

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