An interactive advance care planning intervention to facilitate a good death for cancer patients

To improve end-of-life (EOL) care, the U.S. Institute of Medicine advocates a good death that is “in accord with the patients' and families' wishes.” However, current EOL care does not conform well to patients’ EOL care preferences. Therefore, the primary objectives of this 5-year randomized controlled trial of a theory-based, tailored, multifaceted, interactive ACP intervention are to examine the extent to which the proposed ACP intervention will increase the congruence between terminally ill cancer patients’ preferred and actual EOL care, improve quality of life, depressive symptoms, and anxiety of patients and caregivers during the patient’s dying process, and enhance family caregivers’ bereavement adjustment. The secondary objectives are to determine the effectiveness of the proposed ACP intervention in facilitating patients’ prognostic awareness and EOL care discussions among patients, caregivers, and physicians; in increasing the extent of patient-caregiver agreement on preferences for EOL care; and in reducing aggressive EOL care treatments for terminally ill cancer patients. A convenience sample of 418 patient-caregiver dyads will be randomly assigned to the intervention and attention-control groups equally. The effectiveness will be examined using intention-to-treat regression analyses with generalized estimating equations. Results from this study will contribute to improving EOL care to ensure appropriate EOL care to honor the patient’s preference for EOL care.

Project ID:PG10201-0187
External Project ID:NHRI-EX102-10208PI