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FAmily-CEntered (FACE) Advance Care Planning Among African-American and Non-African-American Adults Living With HIV in Washington, DC: A Randomized Controlled Trial to Increase Documentation and Health Equity.

MedStar author(s):

0885-3924

Name of journal: Journal of pain and symptom managementAbstract: CONCLUSIONS: The FACE ACP intervention significantly improved ACP completion and advance directive documentation in the medical record among both African-American and non-African-American adults living with HIV in Washington, D.C., providing health equity in ACP which can inform best practices.CONTEXT: No prospective studies address disease-specific Advance Care Planning (ACP) for adults living with HIV/AIDS.Copyright (c) 2018. Published by Elsevier Inc.METHODS: Longitudinal, two-arm, randomized controlled trial with intent-to-treat design recruited from 5 hospital-based outpatient HIV clinics in Washington, DC. Adults living with HIV and their surrogate decision makers (N=233 dyads) were randomized to either an intensive facilitated two-session FACE ACP (Next Steps: Respecting Choices goals of care conversation and Five Wishes advance directive) or Healthy Living Control (conversations about developmental/relationship history and nutrition).OBJECTIVE: To examine the efficacy of FAmily-CEntered (FACE) ACP in increasing advance care planning and advance directive documentation in the medical record.RESULTS: Patients (n=223) mean age: 51 years, 56% male, 86% African-American. One hundred ninety-nine dyads participated in the intervention. At baseline, only 13% of patients had an advance directive. Three months post-intervention, this increased to 59% for the FACE ACP group versus 17% in the control group (p<0.0001). Controlling for race, the odds of having an advance directive in the medical record in the FACE ACP group was approximately 7 times greater than controls (Adjusted Odds Ratio=6.58, 95% C.I: 3.21-13.51, p<0.0001). Among African-Americans randomized to FACE, 58% had completed/documented advance directives versus 20% of controls (p<0.0001).All authors: Benator D, Cheng YI, D'Angelo LJ, Greenberg IH, Lyon ME, Scott RK, Squires L, Tanjutco P, Turner MM, Wang J, Weixel TEOriginally published: Journal of Pain & Symptom Management. 2018 Nov 22Fiscal year: FY2019Digital Object Identifier:

https://dx.doi.org/10.1016/j.jpainsymman.2018.11.014

Date added to catalog: 2018-12-14

Holdings ( 1 )
Title notes ( 8 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	30472318	Available		30472318

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

CONCLUSIONS: The FACE ACP intervention significantly improved ACP completion and advance directive documentation in the medical record among both African-American and non-African-American adults living with HIV in Washington, D.C., providing health equity in ACP which can inform best practices.

CONTEXT: No prospective studies address disease-specific Advance Care Planning (ACP) for adults living with HIV/AIDS.

METHODS: Longitudinal, two-arm, randomized controlled trial with intent-to-treat design recruited from 5 hospital-based outpatient HIV clinics in Washington, DC. Adults living with HIV and their surrogate decision makers (N=233 dyads) were randomized to either an intensive facilitated two-session FACE ACP (Next Steps: Respecting Choices goals of care conversation and Five Wishes advance directive) or Healthy Living Control (conversations about developmental/relationship history and nutrition).

OBJECTIVE: To examine the efficacy of FAmily-CEntered (FACE) ACP in increasing advance care planning and advance directive documentation in the medical record.

RESULTS: Patients (n=223) mean age: 51 years, 56% male, 86% African-American. One hundred ninety-nine dyads participated in the intervention. At baseline, only 13% of patients had an advance directive. Three months post-intervention, this increased to 59% for the FACE ACP group versus 17% in the control group (p<0.0001). Controlling for race, the odds of having an advance directive in the medical record in the FACE ACP group was approximately 7 times greater than controls (Adjusted Odds Ratio=6.58, 95% C.I: 3.21-13.51, p<0.0001). Among African-Americans randomized to FACE, 58% had completed/documented advance directives versus 20% of controls (p<0.0001).

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