michael paasche orlow ctac presentation 6.27.13
TRANSCRIPT
Enthusiastic Responses to Advance Care Planning with Video Decision Support Tools
Michael Paasche-Orlow, MD, MA, MPH
Associate Professor of Medicine
Boston University School of Medicine
Goals Share summary observations High level of acceptance of video tools
The Video Images of Disease for Ethical Outcomes (VIDEO) Consortium Led by Dr. Angelo Volandes Completed 13 clinical studies 7 ongoing studies
www.acpdecisions.org Non-Profit Foundation Video Decision Support Tools
Empower patients Improve decision-making
18 scenarios to promote Goals of Care CPR
>50 health care entities
Extensively vetted and tested Short Plain language Cinema vérité Seen together with a provider
Summary Observation #1 Significantly improve decision-making
Knowledge Decision certainty Stability of preferences
Summary Observation #2 Significantly influence preferences
Set limits
Summary Observation #3 Very well accepted by patients
Helpful Comfortable Recommend
90%“Comfortable”
90%“Helpful”
100%“Recommend”
7 minute GOC video for patients with advanced cancer[Control 78% LP or Limited Care vs. Video 4% Limited Care]
93%“Comfortable”
90%“Helpful”
97%“Recommend”
3 minute CPR video for patients with advanced cancer[Control 48% wanted CPR vs. Video 20% wanted CPR]
85%“Comfortable”
88%“Helpful”
95%“Recommend”
2 minute GOC video about advanced dementia[Control 30% LP or Limited vs. Video 12% LP or Limited]
94%“Comfortable”
88%“Helpful”
88%“Recommend”
5 minute generic GOC video studied at SNF [Control 42% LP or Limited vs. Video 20% LP or Limited]
Additional Observations Relieved to talk Felt like a real unmet need Poor communication w/ providers fear
Stuck on machines Poor communication w/ surrogates fear
Burden
Conclusions People are ready for engagement in ACP Current decision-making frequently poor Can be markedly improved
Questions please [email protected] www.acpdecisions.org