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dc.contributor.authorDetering, Karen Men_US
dc.contributor.authorCarter, Rachel Zen_US
dc.contributor.authorSellars, Marcus Wen_US
dc.contributor.authorLewis, Virginiaen_US
dc.contributor.authorSutton, Elizabeth Aen_US
dc.identifier.citationBMJ Supportive & Palliative Care 2017; 7(4): 486-494-
dc.description.abstractOBJECTIVES: Conduct a prospective comparative effectiveness cohort study comparing two models of advance care planning (ACP) provision in community aged care: ACP conducted by the client's case manager (CM) ('Facilitator') and ACP conducted by an external ACP service ('Referral') over a 6-month period. METHODS: This Australian study involved CMs and their clients. Eligible CM were English speaking, ≥18 years, had expected availability for the trial and worked ≥3 days per week. CMs were recruited via their organisations, sequentially allocated to a group and received education based on the group allocation. They were expected to initiate ACP with all clients and to facilitate ACP or refer for ACP. Outcomes were quantity of new ACP conversations and quantity and quality of new advance care directives (ACDs). RESULTS: 30 CMs (16 Facilitator, 14 Referral) completed the study; all 784 client's files (427 Facilitator, 357 Referral) were audited. ACP was initiated with 508 (65%) clients (293 Facilitator, 215 Referral; p<0.05); 89 (18%) of these (53 Facilitator, 36 Referral) and 41 (46%) (13 Facilitator, 28 Referral; p<0.005) completed ACDs. Most ACDs (71%) were of poor quality/not valid. A further 167 clients (facilitator 124; referral 43; p<0.005) reported ACP was in progress at study completion. CONCLUSIONS: While there were some differences, overall, models achieved similar outcomes. ACP was initiated with 65% of clients. However, fewer clients completed ACP, there was low numbers of ACDs and document quality was generally poor. The findings raise questions for future implementation and research into community ACP provision.en_US
dc.subjectAdvance care directive-
dc.subjectAdvance care planning-
dc.subjectCommunity aged care-
dc.subjectHome care packages-
dc.titleProspective comparative effectiveness cohort study comparing two models of advance care planning provision for Australian community aged care clientsen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleBMJ supportive & palliative care-
dc.identifier.affiliationAdvance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia-
dc.identifier.affiliationFaculty of Medicine, Dentistry and Health Sciences, Melbourne University, Melbourne, Victoria, Australia-
dc.identifier.affiliationKolling Institute, Northern Clinical School, The University of Sydney, Camperdown, New South Wales, Australia-
dc.identifier.affiliationAustralian Institute for Primary Care and Ageing, La Trobe University, Melbourne, Victoria, Australia-
dc.type.austinJournal Articleen_US, Karen M
item.fulltextNo Fulltext-
item.openairetypeJournal Article- Care Planning-
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