- An interactive website for patients helped increase patient-led healthcare decision-making by up to 35 percent, according to researchers from the University of California San Francisco (UCSF).
The PREPARE For Your Care website, launched in 2013 by UCSF researchers, guides patients through a series of modules that help them make healthcare decisions and lead advance care planning. Each module consists of instructional videos that use common language to explain complicated health concepts.
Patients can use that information to determine their personal healthcare preferences, needs, and communication styles. At the end the modules, the tool creates a “Summary of Wishes” that patients can share with family and clinicians.
The tool is easy-to-use and requires no clinician administration or patient education, the researchers reported. When all is said and done, each module takes approximately ten minutes to complete.
In a recent analysis of the PREPARE website, Rebecca Sudore, MD, UCSF professor in the Division of Geriatrics, found that the use of advance directives can reinforce PREPARE for Your Care. Advance directives are legal documents that spell out a patient’s specific wishes with regard to their healthcare.
The data, published recently in JAMA Internal Medicine, showed that advance directives on their own can improve patient engagement in decision-making by 25 percent. When used in conjunction with PREPARE for Your Care, these decision aids improve engagement by 35 percent.
Sudore and her colleagues say that the lay language utilized in both tools help make the information digestible and usable for patients, deeming them more effective than other, more complicated decision-making aids.
“One reason may be the use of ADs and other materials written beyond a 12th grade reading level,” the researchers wrote in their report. “The success of both PREPARE and the easy-to-read AD may be explained by their attention to both literacy and cultural considerations designed with and for diverse communities.”
PREPARE further improved patient understanding by including interactive videos, the researchers said.
“The PREPARE website may also help patients engage in [advanced care planning] owing to the inclusion of ‘how-to’ videos that model behavior based on behavior change and social cognitive theories,” the research team said. “In addition, videos have been shown to help patients make end-of-life medical decisions.”
Although the researchers contend that patients will not require physician assistance while using either or both tools, they do acknowledge that some patients will need a nudge from clinicians to begin using them.
“While all care plans should eventually be reviewed by a clinician regardless of whether they are initiated by patient-facing or facilitator-level interventions, these studies suggest that some individuals may need a facilitator to begin to engage in the ACP process,” the researchers said.
Clinicians and patients can both benefit from having patients use the advance directives and PREPARE website, Sudore and colleagues explained.
Advance care planning is integral to the entire patient journey, regardless of whether the patient is facing the end-of-life or has a serious chronic illness. Having patients, clinicians, and family caregivers on the same page will ensure better, more empathic care.
“Advance care planning is much more than just a form; it is all about conversations and patients having a voice in their health care,” Sudore said. “What most excites us about this study is that our easy-to-use tools helped people engage in conversations about their medical wishes with their family, friends and clinicians.”
“We want to break down barriers to advance care planning by providing resources people can use on their own,” Sudore concluded. “The goal is for people to be prepared for medical decision making and to feel empowered to speak up about who they are as a person and what is important to their health care.”