michael paasche orlow ctac presentation 6.27.13
TRANSCRIPT
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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
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Goals Share summary observations High level of acceptance of video tools
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The Video Images of Disease for Ethical Outcomes (VIDEO) Consortium Led by Dr. Angelo Volandes Completed 13 clinical studies 7 ongoing studies
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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
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Extensively vetted and tested Short Plain language Cinema vérité Seen together with a provider
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Summary Observation #1 Significantly improve decision-making
Knowledge Decision certainty Stability of preferences
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Summary Observation #2 Significantly influence preferences
Set limits
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Summary Observation #3 Very well accepted by patients
Helpful Comfortable Recommend
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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]
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93%“Comfortable”
90%“Helpful”
97%“Recommend”
3 minute CPR video for patients with advanced cancer[Control 48% wanted CPR vs. Video 20% wanted CPR]
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85%“Comfortable”
88%“Helpful”
95%“Recommend”
2 minute GOC video about advanced dementia[Control 30% LP or Limited vs. Video 12% LP or Limited]
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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]
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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
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Conclusions People are ready for engagement in ACP Current decision-making frequently poor Can be markedly improved
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Questions please [email protected] www.acpdecisions.org