<?xml version='1.0' encoding='UTF-8'?><xml><records><record><source-app name="HighWire" version="7.x">Drupal-HighWire</source-app><ref-type name="Journal Article">17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Wickersham, Elizabeth</style></author><author><style face="normal" font="default" size="100%">Gowin, Mary</style></author><author><style face="normal" font="default" size="100%">Deen, Munim H.</style></author><author><style face="normal" font="default" size="100%">Nagykaldi, Zsolt</style></author></authors><secondary-authors></secondary-authors></contributors><titles><title><style face="normal" font="default" size="100%">Improving the Adoption of Advance Directives in Primary Care Practices</style></title><secondary-title><style face="normal" font="default" size="100%">The Journal of the American Board of Family
                Medicine</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2019</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2019-03-01 00:00:00</style></date></pub-dates></dates><pages><style  face="normal" font="default" size="100%">168-179</style></pages><doi><style  face="normal" font="default" size="100%">10.3122/jabfm.2019.02.180236</style></doi><volume><style face="normal" font="default" size="100%">32</style></volume><issue><style face="normal" font="default" size="100%">2</style></issue><abstract><style  face="normal" font="default" size="100%">Background: Oklahoma's Advance Directive completion rate is less than 10%. We compared the implementation performance of 2 advance directive forms to determine which form could be more successfully disseminated.Methods: The implementation of the Oklahoma Advance Directive (OKAD) and the Five Wishes form were compared in an 8-month pair-matched cluster randomized study in 6 primary care practices. The outcomes measured during the 22-week implementation included form offering rate, acceptance/completion rate by patients, and documentation in the chart. Twenty semistructured interviews with patients and clinicians were conducted to assess intervention experience.Results: A total of 2748 patient encounters were evaluated. OKAD was offered in 33% of eligible patient visits (493/1494) and accepted 54% of the time (266/493). Five Wishes was offered in 36% of eligible patient visits (450/1254) and accepted 82% of the time (369/450). Unadjusted analyses found no significant difference in offering of advance directive forms between groups. However, the odds of accepting Five Wishes were 3.89 times that of OKAD (95% CI, 2.88 to 5.24; P &lt; .0001). Logistic regression models controlling for several confounders indicated that the acceptance of Five Wishes was favored significantly over OKAD (OR = 1.52; 95% CI, 1.27 to 1.81; P &lt; .0001). Qualitative analyses indicated a clear clinician and patient preference for Five Wishes.Conclusions: Results suggest that Five Wishes was more readable, understandable, appealing, and usable. It seemed to capture patient preferences for end-of-life care more effectively and it more readily facilitated patient-clinician conversations.</style></abstract></record></records></xml>