N/A
N=4,779
Palliative Care Educator
Advance Care Planning · Palliative Care · Alzheimer's Disease and Related Dementias · Doctor-patient Communication · Video Decision Aids
Bottom Line
View on ClinicalTrials.gov: NCT04857060 ↗Enrolled (actual)
4,779
Serious AEs
—
Results posted
Jan 2026
Primary outcome: Primary: Identification of a Goals of Care Conversation in the Electronic Health Record (EHR) During the Index Hospitalization — 3744; 2396 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- ACP Educator led, video assisted discussion (Behavioral)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Tufts Medical Center
- Primary completion
- Oct 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Identification of a Goals of Care Conversation in the Electronic Health Record (EHR) During the Index Hospitalization |
3744; 2396 | — |
| SECONDARY Change in Documentation of Medical Orders for Resuscitation Preferences in EHR |
3562; 2258; 1979; 1242; 2067; 700 | — |
| SECONDARY Caregiver Knowledge of ACP at 12 Months |
4; 4 | — |
| SECONDARY Caregiver Confidence at 12 Months |
15; 15 | — |
| SECONDARY Caregiver Communication Satisfaction at 12 Months |
31; 31 | — |
| SECONDARY Caregiver Decisional Satisfaction at 12 Months |
40; 40 | — |
| SECONDARY Caregiver Decisional Certainty |
2; 2 | — |
Summary
The investigators propose to conduct a stepped wedge cluster randomized trial of an advance care planning (ACP) educator-led intervention among hospitalized patients aged 65 and over, or any patient with Alzheimer's Disease and Related Dementias (ADRD) and their proxy decision-makers in the ward and ICU settings of two major hospitals: Boston Medical Center and North Shore University Hospital in New York. Patient outcomes will be abstracted from electronic health records with Natural Language Processing. The effectiveness of the intervention will be evaluated by comparing the following outcomes among 9,000 hospitalized patients (Aim 1): ACP documentation; preferences for resuscitation; palliative care consults; and, hospice use. The investigators will characterize caregiver-centered outcomes of patients with ADRD, including (Aim 2): (1) knowledge, (2) confidence in future care, (3) communication satisfaction, and (4) decisional certainty in 600 caregivers of patients with ADRD admitted to the hospital. COVID-19 poses a unique dilemma for older Americans and patients with ADRD and their caregivers, who must balance their desire to live against the risk of a lonely and potentially traumatic hospital death. Video decision support is a practical, evidence-based, and innovative approach to assist patients facing such choices. If proven effective, this innovative care model can be immediately deployed across the country to improve the quality of care for millions of Americans.
Eligibility Criteria
Inclusion Criteria: Aim 1
- Inpatient at study sites
- Age 65 and older
Inclusion Criteria: Aim 2 (Caregiver Survey)
- Age 18 and older
- Designated caregiver of inpatient identified in Aim 1 who are diagnosed with Alzheimer's Disease and Related Dementias or other cognitive impairments
- English or Spanish speaking
Exclusion Criteria
- None
Data sourced from ClinicalTrials.gov (NCT04857060). 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.