Evidence map›Paper›PMID 34077563›Full record

ArticleJournal of the American Geriatrics Society2021

Impact of group visits for older patients with heart failure on advance care planning outcomes: Preliminary data.

Sangeeta C Ahluwalia, Julia I Bandini, Alexis Coulourides Kogan, David B Bekelman, Bonnie Olsen, Jessica Phillips, Rebecca L Sudore

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
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

7 authors.

Sangeeta C AhluwaliaRAND Corporation, Santa Monica, California, USA.
Julia I BandiniRAND Corporation, Santa Monica, California, USA.
Alexis Coulourides KoganKeck School of Medicine of USC, Department of Family Medicine and Geriatrics, University of Southern California, Alhambra, California, USA.
David B BekelmanDepartment of Medicine, Eastern Colorado VA HCS, Denver, Colorado, USA.
Bonnie OlsenKeck School of Medicine of USC, Department of Family Medicine and Geriatrics, University of Southern California, Alhambra, California, USA.
Jessica PhillipsRAND Corporation, Santa Monica, California, USA.
Rebecca L SudoreDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA.

Funding

Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their CaregiversK24AG054415 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2017 to 2026
$1.7M
Group Visits for Advance Care Planning Among Older Adults with Heart FailureR21AG053716 · NIA · RAND CORPORATION · PI AHLUWALIA, SANGEETA C · 2017 to 2018
$455k
NIA NIH HHS K24 AG054415NIA NIH HHS R21 AG053716NIA NIH HHS R21-AG053716
6 · The paper itself

Abstract

objectiveAdvance care planning (ACP) is critically important for heart failure patients, yet important challenges exist. Group visits can be a helpful way to engage patients and caregivers in identifying values and preferences for future care in a resource-efficient way. We sought to evaluate the impact of group visits for ACP among older adults with heart failure and their caregivers on ACP-related outcomes.

methodsWe conducted a mixed-methods pilot study evaluating the impact of an ACP group visit for older adults with heart failure and their caregivers on ACP-related outcomes including readiness and self-efficacy. The evidence-based PREPARE for Your Care video-based intervention was used to guide the group visits. Twenty patients and 10 caregivers attended one of the five 90-min group visits led by a trained facilitator. Group visit participants completed pre-, post-, and 1-month follow-up surveys using validated 5-point ACP readiness and self-efficacy scales. Qualitative feedback obtained within 3 days of a group visit was analyzed using a directed content analysis.

resultsPatient participants had a median age of 78 years. Approximately half were female while caregiver participants were mostly female. Participants were predominantly white. Patient readiness scores improved significantly pre-to-post (+0.53; p = 0.002) but was not sustained at 1-month follow-up. Patient and caregiver self-efficacy showed some improvement pre-to-post but was also not sustained at follow-up. Interviews revealed positive impacts of group visits across the three themes: encouraging reviewing or revisiting prior ACP activities, motivating patients to take direct steps towards ACP, and serving as a "wake-up" call to action.

conclusionsDisease-focused group visits may have a short-term effect on ACP outcomes but ongoing touchpoints are likely necessary to sustain ACP over time. The results highlight a need for follow-up ACP conversations after a single group visit. Timing for follow-ups and the ideal person to follow-up ACP conversations needs to be explored.

Indexed as

Advance Care PlanningAgedAged, 80 and overCaregiversFemaleHeart FailureHumansMaleOutcome Assessment, Health CarePilot ProjectsPreliminary DataQualitative ResearchSelf EfficacyShared Medical Appointmentsadvance care planninggroup medical visitsheart failure

Identifiers

PMID34077563
PMCPMC8497395

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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.