Online Tool Helps Patients With Advance Care Planning

TUESDAY, Nov. 13, 2018 -- The patient-facing PREPARE advance care planning program plus an easy-to-read advance directive significantly increases documentation of advance care planning and patient-reported engagement, according to a study published online Oct. 29 in JAMA Internal Medicine.

Rebecca L. Sudore, M.D., from the University of California in San Francisco, and colleagues compared the efficacy of PREPARE For Your Care (a patient-directed, online advance care planning program) plus an easy-to-read advance directive versus an advance directive alone to increase advance care planning documentation and patient-reported engagement among 986 patients of four safety-net, primary care clinics. Patients were randomly assigned to one of the two groups.

The researchers found that of the participants (603 women and 383 men; mean age, 63.3 years), 39.7 percent had limited health literacy and 45.1 percent were Spanish-speaking. PREPARE resulted in a higher adjusted rate of advance care planning documentation (43 versus 32 percent) and higher self-reported increased advance care planning engagement scores (98.1 versus 89.5 percent) compared with the advance directive alone. Results were significant for both English speakers and Spanish speakers.

"These tools may mitigate literacy and language barriers to advance care planning, allow patients to begin planning on their own, and could substantially improve the process for diverse English-speaking and Spanish-speaking populations," the authors write.

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