Trial Outcomes & Findings for EFFICACY: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists (NCT NCT04557930)

Last Updated: 2023-04-10

Results Overview

Percentage of advance care planning bills submitted by physicians in the trial for patients over the age of 65 in the period before and after the roll-out of the video game intervention at their hospital. Advance care planning bills are defined as the presence/absence of ACP charges (Medicare billing codes 99497 or 99498) during a patient's hospitalization.

Recruitment status

COMPLETED

Study phase

Target enrollment

163 participants

Primary outcome timeframe

11 months

Results posted on

2023-04-10

Participant Flow

Dates: July 2020-May 2021 Types of location: acute care hospitals

There was a minimum three month (maximum 7-month) run-in period prior to the exposure of patients to the physicians enrolled in the intervention. We distinguish below between physician participants who enrolled in the trial, and patient participants who were treated by physicians in the trial. The latter group were unconsented.

Unit of analysis: Hospital

Participant milestones

Participant milestones
Measure	Step 1 First group of hospitals randomized to receive the intervention. Pre-intervention phase lasted from Months 0-3; post-intervention phase lasted from Months 4-11	Step 2 Second group of hospitals randomized to receive the intervention. Pre-intervention phase lasted from Months 0-4; post-intervention phase lasted from Months 5-11	Step 3 Third group of hospitals randomized to receive the intervention. Pre-intervention phase lasted from Months 0-5; post-intervention phase lasted from Months 6-11	Step 4 Fourth group of hospitals randomized to receive the intervention. Pre-intervention phase lasted from Months 0-6; post-intervention phase lasted from Months 7-11	Step 5 Fifth group of hospitals randomized to receive the intervention. Pre-intervention phase lasted from Months 0-7; post-intervention phase lasted from Months 8-11
Pre-intervention STARTED	39 8	30 7	25 6	41 7	28 7
Pre-intervention Patient Participants Treated by Enrolled Physician Participants	3203 8	2677 7	3303 6	4976 7	6615 7
Pre-intervention COMPLETED	39 8	30 7	25 6	41 7	28 7
Pre-intervention NOT COMPLETED	0 0	0 0	0 0	0 0	0 0
Post-intervention STARTED	39 8	30 7	25 6	41 7	28 7
Post-intervention Patient Participants Treated by Enrolled Physicians	8076 8	4691 7	3706 6	3949 7	3030 7
Post-intervention COMPLETED	39 8	30 7	25 6	41 7	28 7
Post-intervention NOT COMPLETED	0 0	0 0	0 0	0 0	0 0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

EFFICACY: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Intervention n=163 Participants The control arm occurs prior to receipt of the video game intervention. Each hospital group 'crosses over' from control to intervention at a randomized time point.
Age, Continuous	40 years STANDARD_DEVIATION 7 • n=5 Participants
Sex: Female, Male Female	55 Participants n=5 Participants
Sex: Female, Male Male	108 Participants n=5 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	9 Participants n=5 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	154 Participants n=5 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants
Race (NIH/OMB) Asian	75 Participants n=5 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants
Race (NIH/OMB) Black or African American	15 Participants n=5 Participants
Race (NIH/OMB) White	52 Participants n=5 Participants
Race (NIH/OMB) More than one race	0 Participants n=5 Participants
Race (NIH/OMB) Unknown or Not Reported	21 Participants n=5 Participants
Region of Enrollment United States	163 participants n=5 Participants
Physician Experience in Years of Practice	6.7 years STANDARD_DEVIATION 5 • n=5 Participants
How frequently do you use the Advance Care Planning [ACP] billing codes Always	54 Participants n=5 Participants
How frequently do you use the Advance Care Planning [ACP] billing codes Often	74 Participants n=5 Participants
How frequently do you use the Advance Care Planning [ACP] billing codes Sometimes	28 Participants n=5 Participants
How frequently do you use the Advance Care Planning [ACP] billing codes Rarely	7 Participants n=5 Participants

PRIMARY outcome

Timeframe: 11 months

Population: We analyzed outcomes for patients over 65 admitted for an acute illness, and treated by a trial participant in the pre- and post-intervention periods.

Outcome measures

Outcome measures
Measure	Pre-intervention n=20 Participants Patients treated by trial participants before the roll-out of the intervention at their hospital.	Post-intervention n=23 Participants Patients treated by trial participants after the roll-out of the intervention at their hospital.
Percentage of Patients With Advance Care Planning Bills	5,298 Participants	4,920 Participants

SECONDARY outcome

Timeframe: 11 months

Number of patients who died in the pre-intervention and post-intervention period/total number of patients for both periods

Outcome measures

Outcome measures
Measure	Pre-intervention n=20 Participants Patients treated by trial participants before the roll-out of the intervention at their hospital.	Post-intervention n=23461 Participants Patients treated by trial participants after the roll-out of the intervention at their hospital.
Percentage of Patients Who Died While in Hospital	1625 Participants	1862 Participants

SECONDARY outcome

Timeframe: 11 months

Number of patients readmitted within 7 days/Total number of patients treated in the pre-intervention and post-intervention periods

Outcome measures

Outcome measures
Measure	Pre-intervention n=20 Participants Patients treated by trial participants before the roll-out of the intervention at their hospital.	Post-intervention n=23 Participants Patients treated by trial participants after the roll-out of the intervention at their hospital.
Percentage of Patients Readmitted in 7 Days	756 Participants	750 Participants

SECONDARY outcome

Timeframe: 11 months

Number of patients readmitted within 30-days/Total number of patients in the pre-intervention and post-intervention periods

Outcome measures

Outcome measures
Measure	Pre-intervention n=20 Participants Patients treated by trial participants before the roll-out of the intervention at their hospital.	Post-intervention n=23 Participants Patients treated by trial participants after the roll-out of the intervention at their hospital.
Percentage of Patients Readmitted Within 30-days	2,065 Participants	2,190 Participants

SECONDARY outcome

Timeframe: 11 months

Number of patients who received critical care while admitted/total number of patients admitted in the pre-intervention and post-intervention periods

Outcome measures

Outcome measures
Measure	Pre-intervention n=20 Participants Patients treated by trial participants before the roll-out of the intervention at their hospital.	Post-intervention n=23 Participants Patients treated by trial participants after the roll-out of the intervention at their hospital.
Percentage of Patients Who Received Critical Care	1,065 Participants	1,034 Participants

SECONDARY outcome

Timeframe: 11 months

Duration of hospitalization for patients treated in the pre-intervention and post-intervention periods

Outcome measures

Outcome measures
Measure	Pre-intervention n=20 Participants Patients treated by trial participants before the roll-out of the intervention at their hospital.	Post-intervention n=23 Participants Patients treated by trial participants after the roll-out of the intervention at their hospital.
Length of Stay	6.5 Days Standard Deviation 5.3	6.4 Days Standard Deviation 5.0

Adverse Events

Pre-intervention

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Post-Intervention

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Amber E. Barnato

Dartmouth-Hitchcock

Phone: 603-646-5609

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place