Background In Germany, advance care planning (ACP) was first introduced by law in 2015. Since then, implementation efforts of ACP have been limited to nursing homes and mental health institutional setting. this study aims to evaluate the evaluation of an ACP programme in care dependent community-dwelling older persons.
Methods A cluster-randomised controlled trail of 12 months duration will be conducted in 3 German regions. Using external concealed randomisation, 16 home care services will be allocated to the intervention and 16 to a usual care group (each with 30 participants; n=960). ACP will be delivered by two trained nurse facilitators of the respective home care services. The communication process will include a proxy decision-maker.
Expected results primary endpoint is patient activation, operationalised by the Patient Activation Meassure (PAM-13). Secondary endpoints include ACP-engagement, proportion of advance directives, hospitalisation, quality of life as well as depression and anxiety. An economic evaluation as well as a comprehensive process evaluation will be conducted. After completion of the ongoing pilot study, recruitment will start in June 2019.
Conclusion STADPLAN is the first study internationally that assesses the effects of ACP in community-dwelling older persons and the first study in Germany educating nurses of home care services as ACP facilitatiors. The rsults will support the improvement of understanding and communicating the patient’s will regarding future medical treatment and care, and thereby contribute to patient’s autonomy at the end of life.
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