Sharing health care wishes among older adults with cognitive impairment in primary care: Results from a randomized controlled trial

被引：0

作者：

Wolff, Jennifer L. ^{[1
]}

Cagle, John G. ^{[2
]}

Hanna, Valecia ^{[3
]}

Dy, Sydney M. ^{[3
]}

Echavarria, Diane ^{[4
]}

Giovannetti, Erin R. ^{[5
]}

Boyd, Cynthia M. ^{[6
]}

Saylor, Martha Abshire ^{[7
]}

Hussain, Naaz ^{[8
]}

Reiff, Jenni S. ^{[3
]}

Scerpella, Danny ^{[3
]}

Zhang, Talan ^{[3
]}

Sekhon, Vishaldeep Kaur ^{[9
]}

Roth, David L. ^{[9
]}

机构：

[1] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, 1812 Ashland Ave,Room 326, Baltimore, MD 21205 USA

[2] Univ Maryland, Sch Social Work, Baltimore, MD USA

[3] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA

[4] Johns Hopkins Sch Med, Baltimore, MD USA

[5] MedStar Hlth, Columbia, MD USA

[6] Johns Hopkins Univ, Sch Med, Div Geriatr Med & Gerontol, Baltimore, MD USA

[7] Johns Hopkins Univ, Sch Nursing, Baltimore, MD USA

[8] Johns Hopkins Community Phys, Frederick, MD USA

[9] Johns Hopkins Univ, Div Geriatr Med & Gerontol, Baltimore, MD USA

来源：

ALZHEIMERS & DEMENTIA | 2024年 / 20卷 / 10期

关键词：

advance care planning; cognitive impairment; primary care; randomized controlled trial; OF-LIFE CARE; SERIOUS ILLNESS; THERAPEUTIC ALLIANCE; COMMUNICATION; QUALITY;

D O I：

10.1002/alz.14210

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

INTRODUCTIONBest practices for conducting advance care planning (ACP) among persons with cognitive impairment exist, but evidence-based models are lacking for the primary care setting.METHODSWe tested a remote multicomponent ACP model (SHARE) versus minimally enhanced usual care in 273 person-family dyads from eight primary care practices.RESULTSMean patient age was 88.0 years, 85 (31.1%) were Black/Latino; 189 (69.2%) had moderate-to-severe cognitive impairment. Most (101/145; 69.6%) intervention dyads engaged in ACP. At follow-up, no treatment effect was observed for care partner-reported quality of communication about end-of-life care at 6 or 12 months, but intervention patients reported better quality of communication about end-of-life care at 12 months. Intervention care partners and patients reported greater readiness to engage in ACP at 6 and 12 months, respectively, and increased completion of key aspects of ACP.DISCUSSIONSHARE supported key aspects of ACP processes and communication about end-of-life care.Highlights Primary care-based models of ACP for persons with dementia are lacking. Involving persons with cognitive impairment in remote ACP is feasible with care partner involvement. Results indicate benefit for aspects of ACP processes and communication about end-of-life care.

引用

页码：7263 / 7273

页数：11

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