Clinical Trials Logo

Clinical Trial Summary

This study compares the effectiveness of two different approaches to advance care planning among older African Americans and older Whites living in the community. The two approaches are a structured approach with an advance care planning conversation led by a trained person using Respecting Choices (First Steps) and a patient-driven approach which includes a Five Wishes advance care planning form written in plain language. The study will determine which approach is more effective at increasing advance care planning within each racial group and reducing differences between the two groups in advance care planning.


Clinical Trial Description

Advance care planning (ACP) involves patients making decisions about the kind of medical care they would want to receive if they became unable to speak for themselves. Patients share their wishes in a written document (living will or healthcare proxy) and/or discuss their wishes with family, friends, and doctors. ACP improves the quality of end-of-life care by increasing the likelihood that patients receive care that reflects their preferences and values. Seriously ill African Americans are less likely to take part in advance care planning and experience lower quality care at the end of life, including poorer communication with clinicians and a lower likelihood of receiving the kind of care that they would want.

This study will include 800 seriously or chronically ill community-dwelling older adults (equal number of African Americans and whites) and their caregivers from 10 primary care practices at five medical centers in the Deep South. Eligible patients include those with cancer, advanced heart disease, advanced lung disease, end-stage kidney disease, cirrhosis, diabetes with severe complications, recurrent hospitalizations, or difficulty with basic activities of daily living. For each enrolled patient, one caregiver who is likely to assist the patient with healthcare decisions is also eligible to participate.

The goals of the study are to:

- Compare the effectiveness of two approaches to increasing formal advance care planning (completing written documents like living wills, health care proxies, medical orders for life-sustaining treatments, or other advance directives) and informal advance care planning (having conversations with doctors, family, friends, and others about wishes for future healthcare) for African Americans and for Whites.

- Determine which intervention is most effective in reducing differences between African Americans and Whites in rates of advance care planning.

- Determine whether the effectiveness of the advance care planning approach differs based on whether the person assisting with advance care planning is of the same or different race as the patient.

Administered by community health workers, the two advance care planning approaches which will be compared are:

- Patient-driven approach which includes a Five Wishes Form (advance directive written in easy to understand language)

- Structured approach with an advance care planning conversation led by a trained person using Respecting Choices (First Step) conversation guide. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03516994
Study type Interventional
Source Duke University
Contact Kimberly S Johnson, MD
Phone 919-660-7506
Email kimberly.s.johnson@duke.edu
Status Not yet recruiting
Phase N/A
Start date August 1, 2018
Completion date September 1, 2022

See also
  Status Clinical Trial Phase
Recruiting NCT03089515 - Small Airway Chronic Obstructive Disease Syndrome Following Exposure to WTC Dust N/A
Recruiting NCT03244137 - Effects of Pulmonary Rehabilitation on Cognitive Function in Patients With Severe to Very Severe Chronic Obstructive Pulmonary Disease N/A
Not yet recruiting NCT03282526 - Volume Parameters vs Flow Parameters in Assessment of Reversibility in Chronic Obstructive Pulmonary Disease N/A
Completed NCT02546700 - A Study to Evaluate Safety and Efficacy of Lebrikizumab in Participants With Chronic Obstructive Pulmonary Disease (COPD) Phase 2
Recruiting NCT03295474 - Telemonitoring in Pulmonary Rehabilitation: Feasibility and Acceptability of a Remote Pulse Oxymetry System. N/A
Active, not recruiting NCT03256695 - Evaluate the Relationship Between Use of Albuterol Multidose Dry Powder Inhaler With an eModule (eMDPI) and Exacerbations in Patients With Chronic Obstructive Pulmonary Disease (COPD) Phase 3
Recruiting NCT03414541 - Safety And Efficacy Study Of Orally Administered DS102 In Patients With Chronic Obstructive Pulmonary Disease Phase 2
Completed NCT02552160 - DETECT-Register DocumEnTation and Evaluation of a COPD Combination Therapy N/A
Not yet recruiting NCT03453606 - Respiratory Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease N/A
Recruiting NCT02557178 - Home-Based Health Management of COPD Patients Phase 2
Recruiting NCT02690038 - Ig PRx in AECOPD: Pilot Study Phase 2
Recruiting NCT03467880 - Multicenter Study of Impulse Oscillometry in Chinese N/A
Recruiting NCT02823795 - The Supporting Patient Activation in Transition to Home Intervention N/A
Enrolling by invitation NCT02999685 - Home-based Health Management of Chronic Obstructive Lung Disease (COPD) Patients N/A
Not yet recruiting NCT02892396 - Influence of Electronic Cigarettes in the Evaluation of the Inflammatory Response in Patients With a Diagnosis of COPD N/A
Recruiting NCT02563184 - Seasonal Influenza Vaccine, Quadrivalent Versus Trivalent in Patients With Advanced Chronic Obstructive Pulmonary Disease Phase 4
Recruiting NCT02694796 - Impact of Web and Smartphone-based Physical Activity Program on Physical Activity Level 12 Months After a Balneotherapy N/A
Completed NCT02084758 - Nitrate Supplementation in Chronic Obstructive Pulmonary Disease (COPD) N/A
Completed NCT02519608 - ComparisoN of ticAgrelor vs. Clopidogrel in endoTHeliAl Function of COPD patieNts Phase 2
Completed NCT02750189 - The Economic Burden of Chronic Obstructive Pulmonary Disease(COPD) in South Korea N/A