N/A N=64,915 Randomized Health Services Research

Improving Communication for Primary Care Patients

Advance Care Planning · Dementia

Bottom Line

View on ClinicalTrials.gov: NCT04819191 ↗

Enrolled (actual)

64,915

Serious AEs

—

Results posted

Mar 2025

Primary outcome: Primary: Number of Patients 65 and Older With New Documentation of Any Advance Directive in the Electronic Health Record (EHR) — 2190; 2130; 255; 409 Participants

Study Design & Population

Study type: Interventional
Phase: N/A
Interventions: SHARING Choices (Behavioral)
Age: Older Adult · 65+ yrs
Sex: All
Sponsor: Johns Hopkins University
Primary completion: Nov 2023

Outcome Measures

Outcome	Result	p-value
PRIMARY Number of Patients 65 and Older With New Documentation of Any Advance Directive in the Electronic Health Record (EHR)	2190; 2130; 255; 409; 1699; 1010	—
PRIMARY Occurrence of Potentially Burdensome Procedures Reported Within 6 Months	150; 204; 37; 53	—

Summary

This is a pragmatic trial of SHARING Choices. Components of SHARING Choices include: 1. A letter from the clinic introducing an initiative to prepare persons and families for Advance Care Planning (ACP); 2. Access to a facilitator trained to lead ACP discussions; 3. Patient-family agenda-setting to align perspectives about the role of family and stimulate discussion about ACP; 4. Facilitated registration to the patient portal (for patient and family) as desired; 5. Education & resources about Alzheimer's Disease and Related Dementias (ADRD) for clinic staff.

Eligibility Criteria

Inclusion Criteria

Practices included in this trial are:

Affiliated with Johns Hopkins Community Physicians (JHCP) or MedStar Health;
A primary care practice, defined as adult internal medicine, family medicine, or geriatric medicine;
Have 2 or more practicing clinicians; and
Have more than 500 patients aged 65 and over currently receiving care.

Patients included in this trial are:

Age 65 and older, and
Established patient of primary care clinician at participating practice (>1 prior visit at the clinic). There will be no formal enrollment of participants into this pragmatic trial as this is a clinic-level initiative that will be available and offered to all eligible patients at clinics randomized to the intervention.

Exclusion criteria

Primary care practices affiliated with Johns Hopkins Community Physicians (JHCP) or MedStar Health that are:

Not a primary care practice, defined as adult internal medicine, family medicine, or geriatric medicine;
Have fewer than 2 practicing clinicians; and
Have fewer than 500 patients aged 65 and over currently receiving care.

Patients under the care of primary care practices affiliated with Johns Hopkins Community Physicians (JHCP) or MedStar Health that are:

Less than 65 years of age, or
Not established patients.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04819191). 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.