Evidence map›Paper›PMID 31704762›Full record

ArticleJournal of the American Board of Family Medicine : JABFM

Use of an Ambulatory Patient Portal for Advance Care Planning Engagement.

Adreanne Brungardt, Andrea E Daddato, Bennett Parnes, Hillary D Lum

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Adreanne BrungardtFrom the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO (AB, AED, BP, HDL); VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO (HDL).
Andrea E DaddatoFrom the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO (AB, AED, BP, HDL); VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO (HDL).
Bennett ParnesFrom the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO (AB, AED, BP, HDL); VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO (HDL).
Hillary D LumFrom the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO (AB, AED, BP, HDL); VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO (HDL). Hillary.Lum@ucdenver.edu.

Funding

CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025780 · NCRR · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2008 to 2011
$61.3M
NIH Prior Approval Process ProfessionalUL1TR002535 · NCATS · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2018 to 2022
$51.1M
Refining an Advance Care Planning Group Visit intervention – a novel intervention to engage older adults in advance care planningK76AG054782 · NIA · UNIVERSITY OF COLORADO DENVER · PI LUM, HILLARY · 2016 to 2019
$864k
NCATS NIH HHS UL1 TR002535NCRR NIH HHS UL1 RR025780NIA NIH HHS K76 AG054782
6 · The paper itself

Abstract

backgroundPrimary care clinics need sustainable, population-based approaches to engage patients in advance care planning (ACP). Patient portal-based ACP tools may provide an option for patient engagement.

objectiveTo increase ACP outcomes by engaging older adults through portal-based ACP tools, including an electronic Medical Durable Power of Attorney (MDPOA) form.

methodsGeriatric clinic pilot of a multi-modal population-based outreach strategy for portal-based ACP tools. Outreach was to patients (n = 105) who were 65 years and older with an active portal account, no cognitive impairment, and no MDPOA on file. Patients received a motivational message via the portal and, if not read within 2 weeks, a mailed postcard about the portal-based ACP tools. Primary outcome was composite of any ACP action at 1-year including 1) new advance directive (AD) in the electronic health record, 2) use of portal-based ACP tools, or 3) documented ACP discussion with a provider.

resultsSixty-five older adults read the electronic message at 12 months. Seventeen (16%) engaged in at least 1 ACP action. Fourteen of 17 engaged by adding an AD to their record. More patients completed an AD on article or brought a previously completed AD to clinic, compared with choosing to complete an electronic MDPOA via the portal.

conclusionsBrief motivational messages about ACP via a patient portal is feasible and may increase ACP outcomes for older adults in primary care. Future studies should evaluate population-based portal outreach strategies in combination with team-based workflows to enhance patient engagement in ACP.

Indexed as

Patient PortalsAcademic Medical CentersAdvance Care PlanningAgedAged, 80 and overAmbulatory Care FacilitiesElectronic MailFemaleHealth Services for the AgedHumansMalePatient ParticipationPilot ProjectsQuality ImprovementAdvance Care PlanningAdvance DirectivesDoctor Patient RelationsElectronic Health RecordsEnd of Life CareInternetPatient ParticipationPrimary Health CareQuality ImprovementWorkflow

Identifiers

PMID31704762
PMCPMC7039311

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.