Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI): Protocol for a cluster randomized controlled cross-over trial of life story work and facilitated advance care planning among older Australian adults in community settings
Year: 2024
Type: article
Study design: Study Protocol
Abstract: BACKGROUND: Advance care planning (ACP) is potentially helpful for older adults, however, the rate of uptake in community aged care settings is low. Previous pilot studies suggest that holistic, person-centered ACP approaches may be effective for older adults who experience functional impairment but do not necessarily have life-limiting conditions with clear prognoses. This paper describes the protocol of a randomized trial to test the effectiveness of combined life story work and facilitated ACP in promoting ACP engagement among older adults receiving community aged care services. METHODS: The Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI) trial is an open-label, cross-over, cluster randomized controlled trial with 12 participating aged care organizations in New South Wales and Western Australia. Participants are aged 65 years or older, receiving home care services and capable of providing informed consent at initial recruitment. Recruitment occurs across a two-year period, with study sites randomized to receive the four-session intervention in the first or second year (or a single session 'active control' condition). Primary outcomes are participant-reported ACP engagement and ACP documentation in the aged care client record 12 weeks post-recruitment. Secondary outcomes include measures of decisional conflict, anxiety and depression, meaning-based coping and relationship quality. Analysis will take an intention-to-treat approach. CONCLUSION: This trial tests a novel method of reaching older adults using a holistic, person-centered approach to promoting ACP engagement. Enhancing ACP engagement may reduce decisional conflict, minimize hospital admissions and improve outcomes for people and their families. ANZCTR Trial Registration ID: ACTRN12622001399785.
Source: Contemporary Clinical Trials
Authors: Ava Karusoo-Musumeci, Ling Yeoh, Rebecca Walton, Tiet-Hanh Dao-Tran, Elizabeth Halcomb, Kirsten A. Auret, Josephine M. Clayton, Susan Kurrle, Elissa Campbell, Michelle Hilgeman, Ron Sinclair, Anne Meller, Simon Towler, Caroline E. Edwards, Tracy Comans, Craig Sinclair
Institutions: Neuroscience Research Australia, UNSW Sydney, The University of Queensland, University of Wollongong, The University of Western Australia, The University of Sydney, University of Alabama, Tuscaloosa VA Medical Center, The University of Adelaide, Prince of Wales Hospital, South Eastern Sydney Local Health District, Fiona Stanley Hospital, National Ageing Research Institute
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,930
OpenAlex ID: W4405893767