Advance care planning by all races grew substantially from fall of 2019 through the middle of 2021 for patients at 22 clinics in New York through video intervention, a study published Feb. 24 in JAMA Network Open found.
Advance care planning refers to learning about potential healthcare decisions in advance and informing providers of patient preferences.
Researchers compared advance care planning documentation across three periods: pre–COVID-19 from Sept. 15, 2019, to March 14, 2020; the COVID-19 wave one period from March 15, 2020, to Sept.14, 2020; and an intervention period Dec. 15, 2020, to June 14, 2021, at a New York area ambulatory network of 22 clinics.
During the intervention period, patients were shown video decision aids on topics including advance care planning, COVID-19 and vaccinations. Decision aids were sent to all patients 65 years or older one to two weeks prior to clinic or telehealth appointments and were also available to patients in person before or during their visits.
Five key findings:
- A total of 14,107 patients interacted with clinicians during the pre–COVID-19 period; 12, 806 during wave one; and 15,106 during the intervention period.
- Clinicians documented advance care planning in 3,587 patients during the intervention period, compared to 2,525 during the pre-COVID-19 period and 1,598 during wave one.
- Advance care planning was documented in 447 African American patients during the intervention period compared to 233 during the pre-COVID-19 period and 130 during wave one.
- Advance care planning was documented for 222 Hispanic patients during the intervention period, compared to 127 during the pre–COVID-19 period and 82 (10.2%) during wave one.
- A total of 5,302 videos were viewed during the intervention period, including 4,023 in English and 1,279 in Spanish.
- A total of 4,163 videos were viewed in person during a clinic visit, and 1,139 were viewed via a web link.