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Research ArticleOriginal Research

A Group Visit Initiative Improves Advance Care Planning Documentation among Older Adults in Primary Care

Hillary D. Lum, Rebecca L. Sudore, Daniel D. Matlock, Elizabeth Juarez-Colunga, Jacqueline Jones, Molly Nowels, Robert S. Schwartz, Jean S. Kutner and Cari R. Levy
The Journal of the American Board of Family Medicine July 2017, 30 (4) 480-490; DOI: https://doi.org/10.3122/jabfm.2017.04.170036
Hillary D. Lum
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Rebecca L. Sudore
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Daniel D. Matlock
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Elizabeth Juarez-Colunga
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Jacqueline Jones
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Molly Nowels
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Robert S. Schwartz
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Jean S. Kutner
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Cari R. Levy
the Divisions of Geriatric Medicine (HDL, DDM, RSS) and General Internal Medicine (JSK), Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; the Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver (HDL, DDM, RSS); the Division of Geriatrics, Department of Medicine, University of California, San Francisco (RLS); the San Francisco VA Medical Center, San Francisco (RLS); the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado, Anschutz Medical Campus, Aurora (DDM, EJC); the Colorado School of Public Health, Anschutz Medical Campus, Aurora (EJC, MN); the University of Colorado College of Nursing, Anschutz Medical Campus, Aurora (JJ); and the Denver-Seattle Center on Innovation for Veteran-Centered and Value-Driven Care, Denver VA Medical Center, Denver, CO (CRL).
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Abstract

Introduction: Group visits for advance care planning (ACP) may help patients document preferences for decision makers and future care. We assessed the impact of a primary care-based ACP group visit (ACP-GV) intervention on older adults' ACP documentation and why patients participated.

Methods: Older adults (>65 years) in primary care participated in a 2-session ACP-GV intervention that promotes group dynamics, peer-based learning, and goal setting. Charts were reviewed at baseline, 3 months, and 12 months for documentation of decision makers and ACP forms. We described patients' reasons for participating through analysis of transcripts.

Results: 118 patients (mean age 76 years; 62% female and 82% white) participated in 16 ACP-GV cohorts. From baseline to 3-month follow-up, documentation of decision maker preferences increased from 39% to 81%, and was 89% at 12-month follow-up. Patients with completed ACP forms increased from 20% to 57% at 3 months, and was 67% at 12 months. Reasons for participating included recognizing the importance of ACP, curiosity, participation recommended by primary care provider, desire to talk with family/friends, and desire to complete advance directives.

Conclusions: This ACP-GV intervention increased ACP documentation among patients with diverse reasons for participating. This is a patient-centered approach to ACP in primary care.

  • Advance Care Planning
  • Advance Directives
  • Decision Making
  • Documentation
  • Palliative Care
  • Patient Appointments
  • Primary Health Care
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The Journal of the American Board of Family     Medicine: 30 (4)
The Journal of the American Board of Family Medicine
Vol. 30, Issue 4
July-August 2017
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A Group Visit Initiative Improves Advance Care Planning Documentation among Older Adults in Primary Care
Hillary D. Lum, Rebecca L. Sudore, Daniel D. Matlock, Elizabeth Juarez-Colunga, Jacqueline Jones, Molly Nowels, Robert S. Schwartz, Jean S. Kutner, Cari R. Levy
The Journal of the American Board of Family Medicine Jul 2017, 30 (4) 480-490; DOI: 10.3122/jabfm.2017.04.170036

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A Group Visit Initiative Improves Advance Care Planning Documentation among Older Adults in Primary Care
Hillary D. Lum, Rebecca L. Sudore, Daniel D. Matlock, Elizabeth Juarez-Colunga, Jacqueline Jones, Molly Nowels, Robert S. Schwartz, Jean S. Kutner, Cari R. Levy
The Journal of the American Board of Family Medicine Jul 2017, 30 (4) 480-490; DOI: 10.3122/jabfm.2017.04.170036
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Keywords

  • Advance Care Planning
  • Advance Directives
  • Decision Making
  • Documentation
  • Palliative Care
  • Patient Appointments
  • Primary Health Care

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