COPD Clinical Trial
Official title:
Default Options in Advance Directives for Veterans With Serious Illnesses: A Randomized Clinical Trial
Default options represent the events or conditions that are set into place if no
alternatives are actively chosen. The setting of default options has well-established
effects on a broad range of human decisions, but its influence on patients' preferences for
end-of-life care is only beginning to be understood.
This is a 3-armed randomized clinical trial in Veterans at high risk for critical illness,
assessing the impact of Advance Directive (AD) forms framed with different default options.
The central goals are to assess how default options in ADs influence the end-of-life care
choices made by patients at risk for critical care, and these patients' hospital and ICU
utilization.
The investigators hypothesize that setting defaults in real ADs will increase the proportion
of Veterans selecting comfort-oriented plans of care, decrease selections of life-extending
therapies such as mechanical ventilation and dialysis, and reduce the proportion of time
during follow-up that Veterans spend in the hospital and/or ICU, without affecting patient
satisfaction with end-of-life care planning.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Health Services Research
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