Video Images About Decisions for Ethical Outcomes in the Emergency Department (VIDEO-ED)

Emergencies Clinical Trial

— VIDEO-ED  

Official title:

Using the Emergency Department Visit to Promote Advance Care Planning

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04931797
• Other study ID #: 2021p001552
• Secondary ID: R01AG065254
• Status: Recruiting
• Phase: N/A
• Start date: April 25, 2022
• Est. completion date: June 30, 2025

Study information

• Verified date: March 2024
• Source: Massachusetts General Hospital
• Contact: Angelo Volandes
• Phone: 6177262000
• Email: avolandes[@]partners.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A randomized controlled trial of a video decision aid in the Emergency Department Setting to improve advance care planning documentation.

Description:

A randomized controlled trial of a video decision aid in the Emergency Department setting shown to patients followed by a brief advance care planning discussion and then relay that discussion to the patient's primary care provider and/or admitting clinical team and look at rates of advance care planning documentation in the electronic health record over time. Primary outcome is advance care planning documentation in the EHR at 3 months.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 900
• Est. completion date: June 30, 2025
• Est. primary completion date: December 31, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 50 Years and older

Eligibility

Inclusion Criteria:

• anyone aged 65 and over or anyone aged over 50-64 with an indicator of serious illness

Exclusion Criteria:

• non english or spanish speakers those with a POLST legally blind medically non stable requiring ICU level care

Related Conditions & MeSH terms

• Emergencies

Intervention

Behavioral:
• video decision aid
advance care planning video decision aid
• control arm ACP information sheet
control arm ACP information sheet

Locations

Country	Name	City	State
United States	Brigham and Women's Hospital	Boston	Massachusetts
United States	Massachusetts General Hospital	Boston	Massachusetts
United States	UC Davis	Davis	California
United States	Newton Wellesley Hospital	Newton	Massachusetts

Sponsors (3)

Lead Sponsor	Collaborator
Massachusetts General Hospital	National Institute on Aging (NIA), University of California, Davis

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	EHR documentation of advance care planning	EHR documentation of advance care planning	3 months
Secondary	patient reported conversations with health care providers and family	patient reported conversations with health care providers and family	at 3 and 6 months
Secondary	concordance between stated and documented preferences	concordance between stated and documented preferences	at 3 and 6 months
Secondary	ACP documentation in the EHR	ACP documentation in the EHR	at 6 months
Secondary	hospitalization	hospitalization	at 3 and 6 months
Secondary	differential intervention effects of the ACP video intervention on patient ACP documentation based on race and ethnicity	We will look at ACP documentation in the intervention and control arms to see if there are differential intervention effects based on race and ethnicity. We will look at the ACP documentation rate in Whites in both arms, and compare them to African Americans and Latinx populations. We will be able to see if the intervention had a greater or lesser effect on ACP rates in sub groups of our population by race and ethnicity.	at baseline, 3 and 6 months
Secondary	quality of clinician ACP communication using an ACP quality communication survey	quality of ACP communication using an ACP quality communication survey	quality of communication at the time of the survey interview (baseline), and then at 3 and 6 months
Secondary	place of death	place of death	at 3 and 6 months
Secondary	enrollment in hospice	enrollment in hospice	at 3 and 6 months
Secondary	ED visits	ED visits	at 3 and 6 months
Secondary	mortality	mortality	at 3 and 6 months
Secondary	ICU days	ICU days	at 3 and 6 months
Secondary	patient CPR and breathing machine preferences	we will ask the patient whether or not they want CPR attempted and whether they would wish to be placed on a breathing machine	at time of survey (baseline) and then after 3 and 6 months
Secondary	patient preferences for goals of care	We will ask patient if they wish to receive life prolonging care, limited care or comfort care.	at time of survey (baseline) and then after 3 and 6 months
Secondary	decisional certainty regarding decision making for ACP preferences	we will ask patients how certain they are about their decisions for the goals of care	at baseline survey interview
Secondary	patient knowledge of ACP	We will ask patients knowledge questions about their understanding of advance care planning	at baseline survey interview
Secondary	patient confidence in health care delivery that is aligned with patient preferences	We will ask patients how confident they are in that they will receive the type of medical care they wish in their health care system	at time of survey (baseline) and then after 3 and 6 months
Secondary	patient ACP engagement with ACP topics	We will ask patients how ready and engaged they are with the topic of advance care planning	at baseline survey interview