CPR Decision-Making Clinical Trial
Official title:
A Multifaceted Tool to Improve Decision Making About Cardio-Pulmonary Resuscitation (CPR) for Hospitalized Patients Who Are Seriously Ill
Objective
The primary objective is to evaluate the efficacy of a multi-faceted, clinical decision
support intervention aimed at improving the quality of decisions about Cardio Pulmonary
Resuscitation (CPR) for seriously ill, elderly patients in hospital.
The hypothesis is that fewer patients in the intervention group will have a documented order
for CPR and they will have greater satisfaction with decision making about CPR than patients
in the control group.
Methodological Approach
The study will be a randomized controlled trial comparing a multi-faceted decision support
intervention to usual care for hospitalized patients. The primary objective of this study is
to determine if our multifaceted intervention changes decisions about CPR. The components of
the multifaceted intervention have already been evaluated for feasibility and acceptability
in the hospital setting. The intervention has two parts: the first is a values clarification
exercise, and the second part is a CPR video decision aid that explains the risks and
benefits of CPR as well as the reasons a patient may choose to receive CPR or not. From
previous research it is known that many hospitalized patients have prescribed orders for CPR
despite expressing a preference not to have CPR when asked. Furthermore patients often have
expressed values that are not concordant with their expressed wishes regarding resuscitation.
Therefore it is hypothesized that fewer patients in the intervention group will have a
documented order for CPR and they will have greater satisfaction with decision making about
CPR than patients in the control group.
We will conduct sensitivity analyses to investigate whether the intervention is more
effective among patients who remain in hospital longer after enrollment. We will measure the
intervention effect among patients who remained in hospital for fewer than three days after
enrollment, among patients who were in hospital for 3-7 days after enrollment, and among
patients who remained in hospital for longer than 7 days post-enrollment.
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