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Pragmatic Trials and the Evolution of Serious Illness Research

Pragmatic Trials and the Evolution of Serious Illness Research Advance Care Planning Video Intervention Among Long-Stay Nursing Home Residents Original Investigation Research Invited Commentary Katherine R. Courtright, MD, MS; Scott D. Halpern, MD, PhD The production of evidence regarding how best to care for champions at each intervention NH were instructed to offer people living with and dying from serious illness has pro- videos of their choosing to all eligible residents or their prox- gressed substantially in the past decade. A field dominated by ies at key clinical time points. Overall, roughly half of the 12 479 observational studies with promising results but residual con- residents with advanced illness were ever offered videos, and founding and selection bi- only 1 in 5 viewed them. Compared with usual ACP practices ases has evolved to produce in control NHs, the ACP Video Program did not affect hospital Related article page 1070 transfers, hospice enrollment, or receipt of burdensome treat- many randomized trials. Alas, these trials have tended to be small, often from single cen- ments (tube-feeding, parental therapy, intensive care unit ad- ters, and have tested interventions under highly controlled cir- mission, or invasive mechanical ventilation) over 12 months cumstances, yielding mixed results and limited generalizabil- among residents with or http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Pragmatic Trials and the Evolution of Serious Illness Research

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References (7)

Publisher
American Medical Association
Copyright
Copyright 2020 American Medical Association. All Rights Reserved.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2020.2916
Publisher site
See Article on Publisher Site

Abstract

Advance Care Planning Video Intervention Among Long-Stay Nursing Home Residents Original Investigation Research Invited Commentary Katherine R. Courtright, MD, MS; Scott D. Halpern, MD, PhD The production of evidence regarding how best to care for champions at each intervention NH were instructed to offer people living with and dying from serious illness has pro- videos of their choosing to all eligible residents or their prox- gressed substantially in the past decade. A field dominated by ies at key clinical time points. Overall, roughly half of the 12 479 observational studies with promising results but residual con- residents with advanced illness were ever offered videos, and founding and selection bi- only 1 in 5 viewed them. Compared with usual ACP practices ases has evolved to produce in control NHs, the ACP Video Program did not affect hospital Related article page 1070 transfers, hospice enrollment, or receipt of burdensome treat- many randomized trials. Alas, these trials have tended to be small, often from single cen- ments (tube-feeding, parental therapy, intensive care unit ad- ters, and have tested interventions under highly controlled cir- mission, or invasive mechanical ventilation) over 12 months cumstances, yielding mixed results and limited generalizabil- among residents with or

Journal

JAMA Internal Medicine – American Medical Association

Published: Aug 6, 2020

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