Trial reportJournal of pain and symptom management2019
Concordance Between Proxy Level of Care Preference and Advance Directives Among Nursing Home Residents With Advanced Dementia: A Cluster Randomized Clinical Trial.
Trial report in Journal of pain and symptom management, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06314035 ("Effects of a Decision Support Intervention on End-of-life Care Planning in Chinese Older Adults With Advanced Disease and Their Family Members), which is not on this map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
"Effects of a Decision Support Intervention on End-of-life Care Planning in Chinese Older Adults With Advanced Disease and Their Family Members: A Feasibility Trial"
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Defining end of life in dementia: A systematic review.Palliative medicine · 2021Pooled it
- Palliative care interventions in advanced dementia.The Cochrane database of systematic reviews · 2021Pooled it
- The evidence supporting educational videos for patients and caregivers receiving hospice and palliative care: A systematic review.Patient education and counseling · 2020Pooled it
- Goal Concordance in the Advancing Symptom Alleviation with Palliative Treatment Clinical Trial of a Nurse and Social Worker Palliative Telecare Team Intervention.Journal of palliative medicine · 2026Trial
- Video Intervention and Goals-of-Care Documentation in Hospitalized Older Adults: The VIDEO-PCE Randomized Clinical Trial.JAMA network open · 2023Trial
- Advance Care Planning Video Intervention Among Long-Stay Nursing Home Residents: A Pragmatic Cluster Randomized Clinical Trial.JAMA internal medicine · 2020Trial
- Triggered Palliative Care for Late-Stage Dementia: A Pilot Randomized Trial.Journal of pain and symptom management · 2019Trial
- Advance directives in Finnish long-term care: Do sociodemographic characteristics and regional factors matter?Scandinavian journal of public health · 2026Article
- Using novel natural language processing approaches to examine age-friendly communication about nursing Nome residents with dementia.The Gerontologist · 2026Article
- Needs of key stakeholders to make advance care plans and advance directives for people with dementia: a scoping review.BMC geriatrics · 2025Article
- Differences in Timely Goals of Care Discussions in Nursing Homes Among Black Residents.The American journal of hospice & palliative care · 2025Article
- Commentary: Ethics and Advance Requests for MAiD: Thresholds and Applicability.Healthcare policy = Politiques de sante · 2025Article
- Article
- Future policy and research for advance care planning in dementia: consensus recommendations from an international Delphi panel of the European Association for Palliative Care.The lancet. Healthy longevity · 2024Article
- Relationship between implementation of systematic advance care planning and the quality of death among nursing home residents: a survey.Palliative care and social practice · 2024Article
- Reasons for Discordance Between Life-Sustaining Treatment Preferences and Medical Orders in Nursing Facilities Without POLST.The American journal of hospice & palliative care · 2023Article
- An integrated review: connecting Covid-era hospital visiting policies to family engagement.Frontiers in public health · 2023Review
- Evolution of European Resuscitation and End-of-Life Practices from 2015 to 2019: A Survey-Based Comparative Evaluation.Journal of clinical medicine · 2022Article
- The Role of Regional and State Initiatives in Nursing Home Advance Care Planning Policies.The American journal of hospice & palliative care · 2021Article
- Reasons for discordance and concordance between POLST orders and current treatment preferences.Journal of the American Geriatrics Society · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
contextCare consistent with goals is the desired outcome of advance care planning (ACP).
objectivesThe objectives of this study were to examine concordance between advance directives and proxy care preferences among nursing home residents with advanced dementia and to determine the impact of an ACP video on concordance.
methodsData were from Educational Video to Improve Nursing home Care in End-stage dementia, a cluster randomized clinical trial conducted in 64 Boston-area facilities (32/arm) from 2013 to 2017. Participants included advanced dementia residents and their proxies (N = 328 dyads). At the baseline and quarterly (up to 12 months), proxies stated their preferred level of care for the resident (comfort, basic, or intensive) and advance directives for specific treatments (resuscitation, hospitalization, tube-feeding, intravenous hydration, antibiotics) were abstracted from the charts. At the baseline, proxies in intervention facilities viewed an ACP video. Their care preferences after viewing it were shared via a written communication with the primary care team. At each assessment, concordance between directives and proxy preferences was determined.
resultsAmong the residents (mean age, 86.6 years; 19.5% male), the most prevalent directive was DNR (89.3%) and foregoing antibiotics was least common (parenteral, 8.2%; any type, 4.0%). Concordance between directives and each level of care preference was as follows: comfort, 7%; basic, 49%; and intensive, 58%. When comfort care was preferred, concordance was higher in intervention versus control facilities (10.8% vs. 2.5%; adjusted odds ratio, 2.48; 95% CI, 1.01-6.09).
conclusionBetter alignment between preferences for comfort-focused care and advance directives is needed in advanced dementia. An ACP video may help achieve that goal.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.