Improving advance care planning among older adults

Millions of older adults, especially those with multiple health conditions, are likely to face complex medical decisions over their lifespan for which most are unprepared.

Lack of advance care planning (ACP) has been shown to result in a lack of shared decision making, patients making uninformed choices and a receipt of care inconsistent with their goals and preferences. Yet, despite the existence of reimbursement codes by the Centers for Medicare and Medicaid Services for ACP discussions, these discussions are still not common in primary care.

Many health system leaders have identified ACP as a priority and a critical aspect of value-based care; they need guidance on which tools are most effective and how to incorporate them into everyday practice.

Drs. Erin Kross, professor (Pulmonary, Critical Care, and Sleep Medicine) and director of the Cambia Palliative Care Center of Excellence, and Rebecca Sudore (UCSF) will serve as co-PIs on the pragmatic, comparative effectiveness trial, which will assess the synergistic effects of the UW Jumpstart program, designed to help clinicians start ACP conversations, and the UCSF PREPARE for Your Care program, designed to help patients engage in advance care planning. The study has been funding by the Patient Centered Outcomes Research Institute (PCORI). 

“This research project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other health care stakeholders, but also for its conduct in real-world settings," said PCORI Executive Director Nakela L. Cook, M.D., MPH.

Department of Medicine co-investigators are Dr. Danae Dotolo (Pulmonary, Critical Care and Sleep Medicine) and Dr. Rashmi Sharma (General Internal Medicine).