ArticleTrials2022
Effectiveness of a complex regional advance care planning intervention to improve care consistency with care preferences: study protocol for a multi-center, cluster-randomized controlled trial focusing on nursing home residents (BEVOR trial).
Article in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04333303 (Effect of Advance Care Planning to Improve Patient-centered Care of Nursing Home Residents), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Effect of Advance Care Planning to Improve Patient-centered Care of Nursing Home Residents: Cluster-randomised Controlled Trial
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Models for delivery and co-ordination of primary or secondary health care (or both) to older adults living in aged care facilities.The Cochrane database of systematic reviews · 2024Pooled it
- Care Consistency With Care Preferences in Nursing Homes: A Cluster-Randomized Study of the Effects of an Advance Care Planning Program (BEVOR).Deutsches Arzteblatt international · 2025Trial
- [What really matters can't be planned ahead : Impediments for advance care planning from a qualitative study on very old people living alone].Zeitschrift fur Gerontologie und Geriatrie · 2025Article
- Hospitalizations, emergency medical care utilization, and contacts with the regional on-call medical services among nursing home residents in Germany: a cross-sectional study in 44 nursing homes.BMC health services research · 2025Article
- Training supported by simulated persons to promote the development of specific communication skills in advance care planning.GMS journal for medical education · 2025Article
- [Nursing home-sensitive conditions and approaches to reduce hospitalization of nursing home residents].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Article
Corrections and comments
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Authors and funding
28 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundAccording to recent legislation, facilitated advance care planning (ACP) for nursing home (NH) residents is covered by German sickness funds. However, the effects of ACP on patient-relevant outcomes have not been studied in Germany yet. This study investigates whether implementing a complex regional ACP intervention improves care consistency with care preferences in NH residents.
methodsThis is a parallel-group cluster-randomized controlled trial (cRCT) with 48 NHs (≈ 3840 resident beds) between 09/2019 and 02/2023. The intervention group will receive a complex, regional ACP intervention aiming at sustainable systems redesign at all levels (individual, institutional, regional). The intervention comprises comprehensive training of ACP facilitators, implementation of reliable ACP processes, organizational development in the NH and other relevant institutions of the regional healthcare system, and education of health professionals caring for the residents. Control group NHs will deliver care as usual. Primary outcome is the hospitalization rate during the 12-months observation period. Secondary outcomes include the rate of residents whose preferences were known and honored in potentially life-threatening events, hospital days, index treatments like resuscitation and artificial ventilation, advance directives, quality of life, psychological burden on bereaved families, and costs of care. The NHs will provide anonymous, aggregated data of all their residents on the primary outcome and several secondary outcomes (data collection 1). For residents who have given informed consent, we will evaluate care consistency with care preferences and further secondary outcomes, based on chart reviews and short interviews with residents, surrogates, and carers (data collection 2). Process evaluation will aim to explain barriers and facilitators, economic evaluation the cost implications. DISCUSSION: This study has the potential for high-quality evidence on the effects of a complex regional ACP intervention on NH residents, their families and surrogates, NH staff, and health care utilization in Germany. It is the first cRCT investigating a comprehensive regional ACP intervention that aims at improving patient-relevant clinical outcomes, addressing and educating multiple institutions and health care providers, besides qualification of ACP facilitators. Thereby, it can generate evidence on the potential of ACP to effectively promote patient-centered care in the vulnerable population of frail and often chronically ill elderly.
trial registrationClinicalTrials.gov ID NCT04333303 . Registered 30 March 2020.
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Registered trials
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