Increasing the Uptake of Advanced Directives in SingHealth Polyclinics
NCT ID: NCT03499847
Last Updated: 2019-09-24
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
189 participants
INTERVENTIONAL
2018-03-29
2018-12-19
Brief Summary
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Detailed Description
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A cross-sectional, community-based study surveyed 1200 selected households in Singapore. Only 37.9% of the sample population had heard of the AMD prior to the study, though when approached, 60.6% were willing to sign an AMD. As of 2017, less than 25,000 people (0.45%) in Singapore have opted to sign an AMD.
Past studies have shown that end of life discussions reduce stress, anxiety, and depression in surviving relatives. A local study in 2010 revealed a 33% patient-surrogate discrepancy in end-of-life decision making.
There are a lack of intervention studies regarding AMD in Singapore. In this study, we aim to compare the effectiveness of counselling sessions together with pamphlets, versus pamphlets alone, versus current care, in increasing the completion rates of the AMD in the Singapore Polyclinic setting.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
1. Active Intervention group (n=65) Counselling provided Pamphlet given
2. Passive Intervention group (n=65) Pamphlet given
3. Control group (n=65) Neither counselling nor pamphlet given
HEALTH_SERVICES_RESEARCH
SINGLE
Study Groups
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Active Intervention
subjects will be given a pamphlet about the advanced medical directive, and a standardized face-to-face counselling session will be conducted with their healthcare provider
standardised face-to-face counselling session
the healthcare provider will conduct a standardised face-to-face counselling session guided with subjects guided by a check-list of topics to cover regarding the Advanced Medical Directive.
advanced medical directive pamphlet
A standardised pamphlet containing information about the Advanced Medical Directive produced by the Ministry of Health, Singapore.
Passive Intervention
subjects will be given a pamphlet about the advanced medical directive
advanced medical directive pamphlet
A standardised pamphlet containing information about the Advanced Medical Directive produced by the Ministry of Health, Singapore.
Control
No interventions assigned to this group
Interventions
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standardised face-to-face counselling session
the healthcare provider will conduct a standardised face-to-face counselling session guided with subjects guided by a check-list of topics to cover regarding the Advanced Medical Directive.
advanced medical directive pamphlet
A standardised pamphlet containing information about the Advanced Medical Directive produced by the Ministry of Health, Singapore.
Eligibility Criteria
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Inclusion Criteria
* Patient who seeks medical consultation at Singhealth Polyclinics (Bedok, Marine Parade, Outram, Tampines)
Exclusion Criteria
* History of depression
* Known diagnosis of terminal illness
* Signed Advanced Medical Directive/Advanced Care Plan previously
41 Years
100 Years
ALL
No
Sponsors
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SingHealth Polyclinics
OTHER
Responsible Party
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Xu Cunzhi
Family Medicine Resident
Principal Investigators
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Locations
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Outram Polyclinic
Singapore, , Singapore
Marine Parade Polyclinic
Singapore, , Singapore
Bedok Polyclinic
Singapore, , Singapore
Tampines Polyclinic
Singapore, , Singapore
Countries
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References
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Tay M, Chia SE, Sng J. Knowledge, attitudes and practices of the Advance Medical Directive in a residential estate in Singapore. Ann Acad Med Singap. 2010 Jun;39(6):424-8.
Ramsaroop SD, Reid MC, Adelman RD. Completing an advance directive in the primary care setting: what do we need for success? J Am Geriatr Soc. 2007 Feb;55(2):277-83. doi: 10.1111/j.1532-5415.2007.01065.x.
Azoulay E, Pochard F, Kentish-Barnes N, Chevret S, Aboab J, Adrie C, Annane D, Bleichner G, Bollaert PE, Darmon M, Fassier T, Galliot R, Garrouste-Orgeas M, Goulenok C, Goldgran-Toledano D, Hayon J, Jourdain M, Kaidomar M, Laplace C, Larche J, Liotier J, Papazian L, Poisson C, Reignier J, Saidi F, Schlemmer B; FAMIREA Study Group. Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med. 2005 May 1;171(9):987-94. doi: 10.1164/rccm.200409-1295OC. Epub 2005 Jan 21.
Foo AS, Lee TW, Soh CR. Discrepancies in end-of-life decisions between elderly patients and their named surrogates. Ann Acad Med Singap. 2012 Apr;41(4):141-53.
Houben CHM, Spruit MA, Groenen MTJ, Wouters EFM, Janssen DJA. Efficacy of advance care planning: a systematic review and meta-analysis. J Am Med Dir Assoc. 2014 Jul;15(7):477-489. doi: 10.1016/j.jamda.2014.01.008. Epub 2014 Mar 2.
Tamayo-Velazquez MI, Simon-Lorda P, Villegas-Portero R, Higueras-Callejon C, Garcia-Gutierrez JF, Martinez-Pecino F, Barrio-Cantalejo IM. Interventions to promote the use of advance directives: an overview of systematic reviews. Patient Educ Couns. 2010 Jul;80(1):10-20. doi: 10.1016/j.pec.2009.09.027. Epub 2009 Oct 29.
Xu C, Yan S, Chee J, Lee EP, Lim HW, Lim SWC, Low LL. Increasing the completion rate of the advance directives in primary care setting - a randomized controlled trial. BMC Fam Pract. 2021 Jun 18;22(1):115. doi: 10.1186/s12875-021-01473-1.
Related Links
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Singapore Ministry of Health - Advanced Medical Directives Information
Other Identifiers
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Polyclinics AMD Intervention
Identifier Type: -
Identifier Source: org_study_id
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