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An advance directive programme in nursing homes reduced health services use without affecting patient satisfaction

https://doi.org/10.1136/ebn.3.4.125

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    Molloy DW, Guyatt GH, Russo R, et al.Systematic implementation of an advance directive program in nursing homes: a randomized controlled trial.JAMA2000 Mar 15;283:1437–44OpenUrlCrossRefPubMedWeb of Science

    QUESTION: Does systematic implementation of an advance directive programme in nursing homes affect patient and family satisfaction and reduce healthcare costs?

    Design

    Randomised {allocation concealed}*, blinded {residents}*, controlled trial with 18 months of follow up.

    Setting

    6 nursing homes in Ontario, Canada, each with >100 residents.

    Patients

    1292 nursing home residents.

    Intervention

    6 nursing homes were matched in pairs on key characteristics and randomised 1 home per pair to either an advance directive programme (3 intervention homes, 636 patients) or to continue with usual policies of advance directives (3 control homes, 656 patients). The intervention homes used an advance directive …

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    Footnotes

    • Source of funding: Agency for Healthcare Research and Quality.

    • For correspondence: Dr D W Molloy, Geriatric Research Group, Hamilton Health Sciences Corporation, McMaster University, 711 Concession Street, Hamilton, ON L8V 1C3, Canada. Fax +1 905 575 5121. Abstract and commentary also appear in ACP Journal Club.

    • ↵* Information provided by author.