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   A group visit initiative improves advance care planning documentation among older adults in primary care  
   
نویسنده lum h.d. ,sudore r.l. ,matlock d.d. ,juarez-colunga e. ,jones j. ,nowels m. ,schwartz r.s. ,kutner j.s. ,levy c.r.
منبع journal of the american board of family medicine - 2017 - دوره : 30 - شماره : 4 - صفحه:480 -490
چکیده    Introduction: group visits for advance care planning (acp) may help patients document preferences for decision makers and future care. we assessed the impact of a primary care-based acp group visit (acpgv) intervention on older adults' acp documentation and why patients participated. methods: older adults (>65 years) in primary care participated in a 2-session acp-gv intervention that promotes group dynamics,peer-based learning,and goal setting. charts were reviewed at baseline,3 months,and 12 months for documentation of decision makers and acp forms. we described patients' reasons for participating through analysis of transcripts. results: 118 patients (mean age 76 years; 62% female and 82% white) participated in 16 acp-gv cohorts. from baseline to 3-month follow-up,documentation of decision maker preferences increased from 39% to 81%,and was 89% at 12-month follow-up. patients with completed acp forms increased from 20% to 57% at 3 months,and was 67% at 12 months. reasons for participating included recognizing the importance of acp,curiosity,participation recommended by primary care provider,desire to talk with family/friends,and desire to complete advance directives. conclusions: this acp-gv intervention increased acp documentation among patients with diverse reasons for participating. this is a patient-centered approach to acp in primary care.
کلیدواژه Advance care planning; Advance directives; Decision making; Documentation; Palliative care; Patient appointments; Primary health care
آدرس divisions of geriatric medicine,department of medicine,university of colorado school of medicine,anschutz medical campus,12631 e. 17th ave,aurora,co 80045,united states,veterans affairs eastern colorado geriatric research,education and clinical center,denver, United States, division of geriatrics,department of medicine,university of california,san francisco,united states,san francisco va medical center,san francisco, United States, divisions of geriatric medicine,department of medicine,university of colorado school of medicine,anschutz medical campus,12631 e. 17th ave,aurora,co 80045,united states,veterans affairs eastern colorado geriatric research,education and clinical center,denver,united states,adult and child center for health outcomes research and delivery science,university of colorado,anschutz medical campus,aurora, United States, adult and child center for health outcomes research and delivery science,university of colorado,anschutz medical campus,aurora,united states,colorado school of public health,anschutz medical campus,aurora, United States, university of colorado college of nursing,anschutz medical campus,aurora, United States, colorado school of public health,anschutz medical campus,aurora, United States, divisions of geriatric medicine,department of medicine,university of colorado school of medicine,anschutz medical campus,12631 e. 17th ave,aurora,co 80045,united states,veterans affairs eastern colorado geriatric research,education and clinical center,denver, United States, general internal medicine,department of medicine,university of colorado school of medicine,anschutz medical campus,aurora, United States, denver-seattle center on innovation for veteran-centered and value-driven care,denver va medical center,denver,co, United States
 
     
   
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