Centre d'Atenció Primària Florida Nord, Direcció d'Atenció Primària Costa de Ponent, Catalan Health Institute (ICS), L'Hospitalet de Llobregat, Barcelona, Spain; University Institute in Primary Care Research Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
Centre d'Atenció Primària Florida Nord, Direcció d'Atenció Primària Costa de Ponent, Catalan Health Institute (ICS), L'Hospitalet de Llobregat, Barcelona, Spain.
Patient Educ Couns. 2021 Jan;104(1):207-212. doi: 10.1016/j.pec.2020.06.018. Epub 2020 Jun 18.
To measure the effectiveness of a brief intervention aimed at increasing interest in and use of advanced directives (AD) among primary care patients.
Randomized controlled trial. In the intervention arm, patients were given brief oral information and a leaflet on AD by General Practitioners (GPs), in the control group were briefly informed about the study's purpose. Outcome variables were the proportion of patients who expressed interest in AD and those who completed one. Covariates were sex, age, education, race, Charlson comorbidity index (CCI), religion, and possession of financial will.
Overall, 332 patients were recruited; 58 in the intervention and 36 in the control group expressed interest in AD (p = 0.033) and 18 (5.4 %) made an AD (nine in each group). Variables associated with interest were Caucasian race (odds ratio [OR], 1.88), the intervention (OR, 1.86), and CCI extreme scores (OR, 0.36). Variables associated with AD completion were primary education/no schooling (OR, 5.69) and fewer children (OR, 0.57).
A brief oral and written intervention delivered by GP significantly increased interest in AD and achieved a completion rate of 5.4 %, without differences with the control group.
AD interventions should focus on individuals already likely to be motivated.
测量一项旨在提高初级保健患者对预先指示（AD）的兴趣和使用的简短干预措施的效果。
随机对照试验。在干预组中，由全科医生（GP）向患者提供关于 AD 的简短口头信息和传单，在对照组中，仅简要告知研究目的。结果变量是表示对 AD 感兴趣和完成 AD 的患者比例。协变量为性别、年龄、教育程度、种族、Charlson 合并症指数（CCI）、宗教和财务遗嘱的持有情况。
共招募了 332 名患者；干预组 58 名，对照组 36 名患者对 AD 感兴趣（p=0.033），18 名（5.4%）制定了 AD（每组 9 名）。与兴趣相关的变量是白种人种族（优势比[OR]，1.88）、干预（OR，1.86）和 CCI 极端评分（OR，0.36）。与 AD 完成相关的变量是小学教育/无学历（OR，5.69）和孩子较少（OR，0.57）。
由 GP 提供的简短口头和书面干预措施显著提高了对 AD 的兴趣，并达到了 5.4%的完成率，与对照组无差异。
AD 干预措施应侧重于那些已经有动力的个体。
