TY - JOUR
T1 - Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones
AU - Houben, Carmen H.M.
AU - Spruit, Martijn A.
AU - Luyten, Hans
AU - Pennings, Herman Jan
AU - Van Den Boogaart, Vivian E.M.
AU - Creemers, Jacques P.H.M.
AU - Wesseling, Geertjan
AU - Wouters, Emiel F.M.
AU - Janssen, Daisy J.A.
N1 - Funding Information:
Funding this work was supported by the netherlands lung Foundation, amersfoort, the netherlands (grant number 3.4.12.022).
Publisher Copyright:
© 2019 Author(s) (or their employer(s)).
PY - 2019/4
Y1 - 2019/4
N2 - Rationale: Advance care planning (ACP) is uncommon in patients with chronic obstructive pulmonary disease (COPD). Objectives: To assess whether a nurse-led ACP-intervention can improve quality of patient-physician end-of-life care communication in patients with COPD. Furthermore, the influence of an ACP-intervention on symptoms of anxiety and depression in patients and loved ones was studied. Finally, quality of death and dying was assessed in patients who died during 2-year follow-up. Methods: A multicentre cluster randomised-controlled trial in patients with advanced COPD was performed. The intervention group received an 1.5 hours structured nurse-led ACP-session. Outcomes were: quality of patient-physician end-of-life care communication, prevalence of ACP-discussions 6 months after baseline, symptoms of anxiety and depression in patients and loved ones and quality of death and dying. Results: 165 patients were enrolled (89 intervention; 76 control). The improvement of quality of patient-physician end-of-life care communication was significantly higher in the intervention group compared with the control group (p<0.001). The ACP-intervention was significantly associated with the occurrence of an ACP-discussion with physicians within 6 months (p=0.003). At follow-up, symptoms of anxiety were significantly lower in loved ones in the intervention group compared with the control group (p=0.02). Symptoms of anxiety in patients and symptoms of depression in both patients and loved ones were comparable at follow-up (p>0.05). The quality of death and dying was comparable between both groups (p=0.17). Conclusion: One nurse-led ACP-intervention session improves patient-physician end-of-life care communication without causing psychosocial distress in both patients and loved ones.
AB - Rationale: Advance care planning (ACP) is uncommon in patients with chronic obstructive pulmonary disease (COPD). Objectives: To assess whether a nurse-led ACP-intervention can improve quality of patient-physician end-of-life care communication in patients with COPD. Furthermore, the influence of an ACP-intervention on symptoms of anxiety and depression in patients and loved ones was studied. Finally, quality of death and dying was assessed in patients who died during 2-year follow-up. Methods: A multicentre cluster randomised-controlled trial in patients with advanced COPD was performed. The intervention group received an 1.5 hours structured nurse-led ACP-session. Outcomes were: quality of patient-physician end-of-life care communication, prevalence of ACP-discussions 6 months after baseline, symptoms of anxiety and depression in patients and loved ones and quality of death and dying. Results: 165 patients were enrolled (89 intervention; 76 control). The improvement of quality of patient-physician end-of-life care communication was significantly higher in the intervention group compared with the control group (p<0.001). The ACP-intervention was significantly associated with the occurrence of an ACP-discussion with physicians within 6 months (p=0.003). At follow-up, symptoms of anxiety were significantly lower in loved ones in the intervention group compared with the control group (p=0.02). Symptoms of anxiety in patients and symptoms of depression in both patients and loved ones were comparable at follow-up (p>0.05). The quality of death and dying was comparable between both groups (p=0.17). Conclusion: One nurse-led ACP-intervention session improves patient-physician end-of-life care communication without causing psychosocial distress in both patients and loved ones.
KW - Palliative care
KW - 22/4 OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85060198850&partnerID=8YFLogxK
U2 - 10.1136/thoraxjnl-2018-211943
DO - 10.1136/thoraxjnl-2018-211943
M3 - Article
AN - SCOPUS:85060198850
SN - 0040-6376
VL - 74
SP - 328
EP - 336
JO - Thorax
JF - Thorax
IS - 4
ER -