Online module promotes advance directives documentation

Reference

Sudore RL, Schillinger D, Katen MT, et al. Engaging diverse English- and Spanish-speaking older adults in advance care planning. The PREPARE randomized clinical trial. JAMA Intern Med 2018;178(12):1616-1625.

Synopsis

These investigators enrolled 986 English-speaking or Spanish-speaking (45%) primary care patients, mean age 63.3 years, with 2 or more chronic or serious illnesses. Approximately 40% of the group had low health literacy. The patients were randomized, concealed allocation unknown, to receive an advance directive form to take home, or to receive the same form and computer access to review the PREPARE online module. Patients in both groups were asked about advance care planning at a subsequent visit. Within 15 months of the initial exposure to the interventions, 43% of patients who reviewed the online module had documented advance directives compared with 33.1% in the paper-only group (number needed to treat = 10). Results were significant in both English-speaking and Spanish-speaking patients. This is a proof-of-concept study (efficacy study) and the results might not be the same if patients were asked to go home and review the online module on their own computers. As they say in advertisements, your results may differ.