The University of California, Los Angeles has announced an $8.4 million grant from the Patient-Centered Outcomes Research Institute to develop more effective approaches to advance care planning for seriously ill patients in primary care settings.
Focused on the needs of both patients and caregivers, the grant will support efforts by UCLA researchers, in collaboration with researchers from UC San Francisco and UC Irvine, to evaluate three planning approaches that could be used in primary care clinics for people with advanced cancer, heart failure, and lung disease. The aim is to determine which approach, or approaches, leads the patient to complete an advance directive, a legal document that describes the patient’s wishes for end-of-life care. Advance care planning is a process that involves patients, families, and clinicians in a collective effort to better understand a patient’s illness and prognosis and help clarify treatment preferences, identify a surrogate, and develop goals for care as the illness progresses and near the end of life.
To that end, primary care clinics at the three universities will test strategies in which patients are introduced to the advance directive, are given the advance directive and instructed to use a Web tool called Prepare for Your Care to make clear their wishes, or are guided by specially trained coordinators to engage with the advance directive and the interactive website.
"Interventions to promote advance care planning are particularly important at academic health systems such as UCLA, UCSF, and UC Irvine, where this trial will be conducted," said Neil Wenger, professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and director of the UCLA Health Ethics Center. "Patients at these locations expect to receive the most advanced medical treatments. It is important to target the clinical expertise and advanced technologies to achieve the specific goals of the individual patient."