Effects of the ACP-MOST video on primary and secondary outcomes
| Instrument: measure | All units* | Medical unit | Surgical unit | ||||||
| Usual care (n=108) | Video intervention (n=142) | P value | Usual care (n=15) | Video intervention (n=39) | P value | Usual care (n=76) | Video intervention (n=94) | P value | |
| Primary outcome | |||||||||
| Patient ACP Knowledge Quiz: median % score (IQR) | 70 (40, 90) | 100 (90, 100) | <0.0001 | 70 (30, 90) | 90 (80, 100) | 0.003 | 60 (50, 90) | 100 (90, 100) | <0.0001 |
| Secondary outcomes | |||||||||
| MOST completed <48 hours of admission: n (%) | 87 (81) | 130 (92) | 0.01 | 14 (93) | 34 (87) | 1 | 60 (79) | 87 (93) | 0.01 |
| MOST concordance, n (%) | 75 (69) | 127 (89) | <0.0001 | 11 (73) | 35 (90) | 0.1 | 51 (67) | 84 (89) | 0.0003 |
| CANHELP: overall satisfaction, median (IQR) | 4.3 (4.0, 4.7) | 4.4 (4.1, 4.7) | 0.2 | 4.2 (3.8, 4.7) | 4.3 (4.0, 4.5) | 1 | 4.2 (4.0, 4.6) | 4.5 (4.1, 4.7) | 0.01 |
| CANHELP: decision- making, median (IQR) | 4.3 (3.8, 4.8) | 4.5 (4.3, 4.8) | 0.001 | 4.3 (3.8, 4.5) | 4.5 (4.0, 4.8) | 0.7 | 4.3 (3.8, 4.5) | 4.5 (4.3, 4.8) | <0.0001 |
| SURE Test score (4/4), n (%) | 78 (72) | 132 (93) | <0.0001 | 10 (67) | 37 (95) | 0.008 | 57 (75) | 86 (92) | 0.008 |
The primary outcome was patients’ understanding of key ACP concepts. Secondary outcomes were ACP documentation completed within 48 hours of hospital admission, concordance between patients’ expressed and chart-documented wishes for care, patients’ satisfaction with decision-making and patients’ decisional confidence.
*Values in bold indicate significant differences at p<0.05.
*Includes medical, surgical, telemetry and intensive care unit (ICU). Telemetry and ICU-specific results are not shown due to small sample size. Telemetry usual care n=9, video intervention n=7, no outcomes significant at p<0.05. ICU usual care n=8, video intervention n=2, no outcomes significant at p<0.05.
ACP, advance care planning; CANHELP, Canadian Health Care Evaluation Project; MOST, Medical Order for Scope of Treatment; SURE, Sure of myself, Understand information, Risk/benefit ratio and Encouragement.