Evidence map›Paper›PMID 39126153›Full record

ArticleJournal of the American Geriatrics Society2024

Action plans increase advance care planning documentation and engagement among English and Spanish-speaking older adults.

Clarissa M Ferguson, Joni Gilissen, Charlotte Scheerens, Aiesha Volow, Jana Powell, Ying Shi, Ryan McMahan, Deborah Barnes, Rebecca L Sudore

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. 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

9 authors.

Clarissa M FergusonDepartment of Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Joni GilissenDepartment of Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-5388-495X
Charlotte ScheerensDepartment of Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Aiesha VolowDepartment of Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Jana PowellDepartment of Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Ying ShiSan Francisco VA Medical Center, San Francisco, California, USA.
Ryan McMahanSan Francisco VA Medical Center, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-5572-0513
Deborah BarnesDepartment of Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Rebecca L SudoreDepartment of Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA.

Funding

Race/ethnic Differences Among Older Patients with Type 2 Diabetes at Risk for HypoglycemiaR01AG068133 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI GRANT, RICHARD W, SUDORE, REBECCA L · 2020 to 2024
$3.7M
Improving advance care planning for seniors at risk for Alzheimers disease and related dementias and their caregiversR01AG045043 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI SUDORE, REBECCA L · 2013 to 2017
$3.2M
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
NIA NIH HHS 3R01AG068133-03S1NIA NIH HHS K24 AG054415NIA NIH HHS K24AG054415NIA NIH HHS R01 AG045043NIA NIH HHS R01AG045043NIA NIH HHS R01 AG068133
6 · The paper itself

Abstract

backgroundAdvance care planning (ACP) has been reconceptualized as a health behavior. Action plans (APs), or patient-directed mini contracts, improve behavior change. However, no prior studies have assessed whether APs can increase ACP documentation and engagement.

methodsWe included English and Spanish-speaking primary care patients from San Francisco, ≥55 years of age, with ≥2 serious or chronic illnesses. Participants were in the intervention arm of the PREPAREforYOURcare.org trial and asked at baseline to choose 1 of 5 actions (e.g., choose a surrogate). At 6 months, we assessed whether participants completed their AP and if completion was associated with demographics, electronic health record (EHR) ACP documentation, and five-point ACP Engagement Survey scores. We used t-tests, chi-squared, multivariate analysis adjusted for baseline ACP and clustering by physician, and qualitative thematic analysis to explore reasons for non-completion.

resultsThe mean age of 586 participants was 65 ± 10 years; 44.0% women, 45.9% Spanish-speaking, 31.4% had limited health literacy, and 43% completed an AP at 6 months; surrogate-related (47.4%), tell others about medical wishes (33.7%), ask clinicians questions (13.7%), and decide what matters most in life (5.2%). Participants with limited versus adequate health literacy were less likely to complete an AP (25.4% vs 35.9%, p = 0.01). Completing an AP was associated with greater ACP EMR documentation 49.8% vs 35.6%, p < 0.001 (adjusted odds ratio: 2.06; 95% CI [1.43-2.97]) and engagement (adjusted five-point scores [3.69; 95% CI 3.57-3.81 vs 3.10; 95% CI: 2.98-3.21], p < 0.001). Themes for non-completion included not being ready and logistical issues (e.g., surrogate deceased).

conclusionsAmong English and Spanish-speaking older adults, creating an ACP AP resulted in greater documentation and engagement. APs may help facilitate ACP behavior change as part of effective ACP interventions. Additional support may be needed for patients with limited health literacy and those facing logistical barriers.

Indexed as

Advance Care PlanningDocumentationAgedElectronic Health RecordsFemaleHealth LiteracyHispanic or LatinoHumansLanguageMaleMiddle AgedPatient ParticipationPrimary Health CareSan FranciscoWhiteaction plansadvance care planningaging

Identifiers

PMID39126153
PMCPMC11637950

What OpenQuestion holds

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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.