Effect of the STAMP (Sharing and Talking About My Preferences) Intervention on Completing Multiple Advance Care Planning Activities in Ambulatory Care : A Cluster Randomized Controlled Trial.
Effect of the STAMP (Sharing and Talking About My Preferences) Intervention on Completing Multiple Advance Care Planning Activities in Ambulatory Care : A Cluster Randomized Controlled Trial.
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DOI：
10.7326/m21-1007
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发表时间：
2021-11
影响因子：
39.2
通讯作者：
Rossi JS
中科院分区：
文献类型：
--
作者：
Fried TR;Paiva AL;Redding CA;Iannone L;O'Leary JR;Zenoni M;Risi MM;Mejnartowicz S;Rossi JS
为了实现预先护理计划（ACP）的生命全程方法，有必要在门诊环境中进行具有广泛影响的干预措施。旨在检查基于计算机定制的、基于行为健康模型的干预措施对从流动环境中招募的 ACP 成年人参与度的影响。具有参与者水平分析的整群随机对照试验。十对初级和选定的专业护理实践与患者的社会人口统计信息相匹配。 55 岁及以上的说英语的人； 455 例随机接受常规护理，456 例随机接受干预。简短的电话或基于网络的评估，生成邮寄的单独定制的反馈报告，以及基线、两个月和四个月的阶段匹配小册子。主要成果：在六个月内完成四项 ACP 活动：识别并与值得信赖的个人沟通对生活质量与数量的看法、指定医疗代理人、填写生前遗嘱、确保文件包含在由盲审员评估的医疗记录中。次要成果：完成个人 ACP 活动。参与者中 64% 为女性，76% 为白人，平均年龄为 68.3 (8.3) 岁。常规护理场所完成所有 ACP 活动的预测概率为 8.2%（95% 置信区间 4.9%、11.4），而干预场所完成所有 ACP 活动的预测概率为 14.1%（95% 置信区间 11.0%、17.2%）（调整后风险差异 5.2%、95% 置信区间 1.6%、8.8%）。预先指定的亚组分析表明干预措施与年龄、教育或种族之间没有统计学上显着的相互作用。该研究是在单一地区进行的，排除了非英语参与者。没有收集有关非参与者的信息。简短且易于交付的定制打印干预措施增加了门诊护理环境中 ACP 的参与度。临床试验.gov：NCT03137459。
Interventions with potential for broad reach in ambulatory settings are necessary to achieve a life course approach to advance care planning (ACP). To examine the effect of a computer-tailored, behavioral health model-based intervention on engagement of adults in ACP recruited from ambulatory settings. Cluster randomized controlled trial with participant-level analysis. Ten pairs of primary and selected specialty care practices matched on patient sociodemographic information. English-speaking persons age 55 and older; 455 at practices randomized to usual care and 456 at practices randomized to intervention. Brief telephone or web-based assessment generating a mailed individually tailored feedback report with a stage-matched brochure at baseline, two, and four months. Primary outcome: completion of four ACP activities at six months: identifying and communicating with a trusted individual about views on quality versus quantity of life, assignment of a healthcare agent, completion of a living will, ensuring that documents are in the medical record assessed by a blinded interviewer. Secondary outcomes: completion of individual ACP activities. Participants were 64% women, 76% white, with a mean age of 68.3 (8.3) years. Predicted probability of completing all ACP activities in usual care sites was 8.2% (95% confidence interval 4.9%, 11.4) compared to 14.1% (95% confidence interval 11.0%, 17.2%) in intervention sites (adjusted risk difference 5.2%, 95% confidence interval 1.6%, 8.8%). Prespecified subgroup analysis demonstrated no statistically significant interactions between the intervention and age, education, or race. The study was conducted in a single region and excluded non-English speaking participants. No information was collected about non-participants. A brief and easily delivered tailored print intervention increased participation in ACP in ambulatory care settings. Clinicaltrials.gov: NCT03137459.
影响因子：
13.8
作者：
Wright, Davene R.
通讯作者：
Wright, Davene R.