N/A
Completed N=103,048
Pragmatic Trial of Video Education in Nursing Homes
Source: ClinicalTrials.gov NCT02612688 ↗Enrolled (actual)
103,048
Serious AEs
0.0%
Results posted
Jun 2020
Primary outcomePrimary: Hospital Transfer Rate in Target Cohort — 2.4; 2.8 person-years
Summary
This is a pragmatic cluster-randomized control trial (RCT) of an Advance Care Planning (ACP) Video Program for nursing home (NH) patients ≥ 65 years old who are cared for in 360 NH facilities (intervention arm n=119; control arm n=241) within two NH health care systems: Genesis HealthCare and PruittHealth. The intervention NH facilities will implement the ACP Video Program, while the control NH facilities will follow their usual ACP procedures. The trial will evaluate the effectiveness of the ACP Video Program by comparing hospitalizations, advance directives, and hospice use in the intervention vs. control NHs.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Hospital Transfer Rate in Target Cohort |
2.4; 2.8 | — |
| SECONDARY Hospital Transfer Rate Among Long-stay Residents Without Advanced Illness |
1.65; 1.68 | — |
| SECONDARY Hospital Transfer Rate Among Short-stay Residents With Advanced Illness |
6.9; 6.8 | — |
| SECONDARY Hospital Transfer Rate Among Short-stay Residents Without Advanced Illness |
4.5; 4.4 | — |
| SECONDARY Proportion of Target Cohort With Last Observed Advance Directive Status |
295; 570; 1288; 2010; 387; 300 | — |
| SECONDARY Proportion of Long-stay Residents Without Advanced Illness With Last Observed Advance Directive Status |
1150; 2210; 1714; 3018; 369; 431 | — |
| SECONDARY Proportion of Short-stay Residents With Advanced Illness With Last Observed Advance Directive Status |
482; 761; 581; 858; 103; 82 | — |
| SECONDARY Proportion of Short-stay Residents Without Advanced Illness With Last Observed Advance Directive Status |
8289; 12899; 4541; 6392; 462; 493 | — |
| SECONDARY Proportion of Target Cohort Receiving Any Burdensome Treatment |
453; 971 | — |
| SECONDARY Proportion of Long-stay Residents Without Advanced Illness Receiving Any Burdensome Treatment |
465; 1028 | — |
| SECONDARY Proportion of Short-stay Residents With Advanced Illness Receiving Any Burdensome Treatment |
294; 621 | — |
| SECONDARY Proportion of Short-stay Residents Without Advanced Illness Receiving Any Burdensome Treatment |
1726; 3405 | — |
| SECONDARY Proportion of Target Cohort With Any Hospice Enrollment |
904; 1878 | — |
| SECONDARY Proportion of Long-stay Residents Without Advanced Illness With Any Hospice Enrollment |
373; 832 | — |
| SECONDARY Proportion of Short-stay Residents With Advanced Illness With Any Hospice Enrollment |
588; 1220 | — |
| SECONDARY Proportion of Short-stay Residents Without Advanced Illness With Any Hospice Enrollment |
2273; 4875 | — |
| SECONDARY Proportion of Target Cohort That Has Medicare ACP Billing Codes |
356; 685 | — |
| SECONDARY Proportion of Long-stay Residents Without Advanced Illness That Has Medicare ACP Billing Codes |
571; 1157 | — |
| SECONDARY Proportion of Short-stay Residents With Advanced Illness That Has Medicare ACP Billing Codes |
224; 479 | — |
| SECONDARY Proportion of Short-stay Residents Without Advanced Illness That Has Medicare ACP Billing Codes |
1669; 4068 | — |
Eligibility Criteria
Inclusion Criteria
- Facilities are within Genesis HealthCare or PruittHealth health care systems
- Facilities have facility identifiers that indicate that they are Medicare/Medicaid-certified nursing facilities in the U.S.
- Facilities serve both short and long-stay patients
- Facilities have >50 beds
- Facilities have an electronic medical records system
- Facilities had at least 20 admissions and 20 annual Minimum Data Set (MDS) assessments (regardless of whether they were discharged alive) in 2013
Exclusion Criteria
- Facilities excluded per corporate leaders in health care system because of recent turnover in NH administrator or Director of Nursing
- Facilities excluded per corporate leaders in health care system because of recent bad state or federal quality assurance survey (e.g. restriction on admissions, levied large civil monetary penalty, etc.)
- Facilities excluded per corporate leaders in health care system because of current new initiatives/competing demands
Data sourced from ClinicalTrials.gov (NCT02612688). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.