Treatment for Advance Care Planning

1
Effectiveness
1
Safety
UPMC Hillman Cancer Center, Pittsburgh, PA
+1 More
Eligibility
18+
All Sexes
Eligible conditions
Advance Care Planning

Study Summary

This study is evaluating whether a web-based ACP program is as effective as in-person ACP.

See full description

Eligible Conditions

  • Advance Care Planning
  • Malignancies

Treatment Effectiveness

Effectiveness Estimate

1 of 3

Study Objectives

This trial is evaluating whether Treatment will improve 1 primary outcome, 10 secondary outcomes, and 8 other outcomes in patients with Advance Care Planning. Measurement will happen over the course of 12 weeks.

12 weeks
Advance care planning engagement
advance care planning discussions with caregivers
advance care planning discussions with physicians
advance directive completion
documented care goals
Month 60
caregiver depression symptoms
Month 60
caregiver anxiety symptoms
Month 60
Healthcare utilization at end of life - ED visits
Healthcare utilization at end of life - ICU
Healthcare utilization at end of life - chemotherapy
Healthcare utilization at end of life - hospice
Healthcare utilization at end of life - hospice < 3 days
Healthcare utilization at end of life - hospice length of stay
Healthcare utilization at end of life - hospitalizations
Receipt of goal-concordant end-of-life care - patient wishes followed
Receipt of goal-concordant end-of-life care - place of death
caregiver post-traumatic stress symptoms
quality of end-of-life care
Year 5
advance care planning implementation costs

Trial Safety

Safety Estimate

1 of 3

Trial Design

2 Treatment Groups

Web-based advance care planning

This trial requires 700 total participants across 2 different treatment groups

This trial involves 2 different treatments. Treatment is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Web-based advance care planning
Behavioral
Patients randomized to this arm will participate in web-based ACP via the PREPARE website.
Facilitated advance care planning (in-person or telephonic)
Behavioral
Patients randomized to this arm will participate in in-person or telephonic facilitated advance care planning (ACP) discussions using the Respecting Choices model.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: through study completion, up to 5 years
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly through study completion, up to 5 years for reporting.

Who is running the study

Principal Investigator
Y. S. M.
Prof. Yael Schenker, MAS, MD
University of Pittsburgh

Closest Location

UPMC Hillman Cancer Center - Pittsburgh, PA

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 6 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
You are at increased risk of HIV infection if you are under 18 years of age. show original
Solid tumor The oncologist "would not be surprised" if the patient died within the next year
The ECOG PS is 0, 1, or 2. show original
Planning to receive ongoing care at a participating oncology clinic
You are willing to participate in either a web-based or facilitated program. show original
Patient

Patient Q&A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What are the signs of advance care planning?

Add answer

Many adults live in the emergency department, yet are unable to request specific medical treatment options. Advance care planning may be particularly beneficial to seniors in the ED.

Unverified Answer

What causes advance care planning?

Add answer

Advance care planning can have a powerful impact on people’s lives. However, as much as half of those surveyed never consider a plan, while a large proportion of them do not complete one after an episode. When people contemplate an advance plan they tend to overestimates their ability to manage their wishes, or they do not think it is for them.

Unverified Answer

Can advance care planning be cured?

Add answer

Results from a recent clinical trial showed little difference from other studies in the ability of this intervention to improve the quality of end of life. Despite the small number of participants as well as the non-randomisation of some aspects of the study, nonetheless, this trial shows promise and could lead to the better care of frail elders if further study is undertaken.

Unverified Answer

What are common treatments for advance care planning?

Add answer

Many individuals with terminal illnesses and their families make advance care decisions in anticipation of impending grief during life-threatening and persistent illness. Advance discussions of end-of-life care are often underrepresented in the conversations surrounding medical treatment decisions.

Unverified Answer

How many people get advance care planning a year in the United States?

Add answer

Between one in three and one in five Americans over the age of 70 get advance care planning. However, many seniors do not know their advance care plans and thus do not receive them. A system for facilitating the creation of advance care plans could alleviate these deficiencies.

Unverified Answer

What is advance care planning?

Add answer

Advance care planning is a health-care value. Advance care planning is a process to help people make a coherent end-of-life decision and prepare them to deal with their physical and emotional needs, and to ensure that their wishes are respected and their best interests are pursued. [corrected] Patients who have done the advance directive have rated their care more favorably and had more positive evaluations than those who did not.

Unverified Answer

What is the primary cause of advance care planning?

Add answer

Healthcare professionals and caregivers should routinely ask patients about advance care planning and should discuss it in detail with all patients who want to consider making such a decision.

Unverified Answer

Is treatment safe for people?

Add answer

For patients who develop CML-CML, the survival rate can be improved if they have a multidisciplinary program in the early stages of the disease. Moreover, the program should consist of early detection, personalized therapy and counseling to overcome the fear of treatment. In addition, the follow-up visit program can be introduced in order to determine if the disease recurs. Thus, we believe that the early program is essential for the treatment of elderly patients. We hope that this report will help physicians to provide appropriate treatment for elderly patients.

Unverified Answer

Is treatment typically used in combination with any other treatments?

Add answer

We found that combination therapies were typically used and more frequently used than monotherapy in the UK. Some people in the UK may be receiving inadequate care, particularly in the provision of multidisciplinary services.

Unverified Answer

What does treatment usually treat?

Add answer

Patient attitudes and medical histories do not help us anticipate the best treatment for all patients. But health plan providers will try to take into account each patient's needs when making treatment decisions. Many health insurance companies must balance budget, so they pay providers to decide which treatments to invest in. They must decide how much to spend on research to find cures against many diseases. They must decide whether to pay for research to make a drug even though that drug gets a 5% profit margin before it comes off the market. What else can providers do besides decide what to make? What else can administrators and health plans do to help patients get the best care? They should do more than just decide which treatments to invest in.

Unverified Answer

Have there been any new discoveries for treating advance care planning?

Add answer

This review revealed more information on the role of hormones and growth factors than they [were] previously thought, and also on some of the clinical studies that supported the use of growth factors for the treatment of a variety of cancers. However, we found no new, conclusive evidence that would support the use of growth factors in the treatment of advanced cancer.

Unverified Answer

How serious can advance care planning be?

Add answer

Advances in end-of-life care include provision of information regarding how to engage as an empowered decision-maker versus a decision-making role that is supportive and a burdensome, passive role; and that an advance care planning document includes a plan of care and a futility statement. These elements are important when considering prognosis, end-of-life care, and the appropriateness of advance directives.

Unverified Answer
See if you qualify for this trial
Get access to this novel treatment for Advance Care Planning by sharing your contact details with the study coordinator.