TY - JOUR
T1 - Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI)
T2 - Protocol for a cluster randomized controlled cross-over trial of life story work and facilitated advance care planning among older Australian adults in community settings
AU - Karusoo-Musumeci, Ava
AU - Yeoh, Ling
AU - Walton, Rebecca
AU - Dao-Tran, Tiet Hanh
AU - Halcomb, Elizabeth
AU - Auret, Kirsten A.
AU - Clayton, Josephine M.
AU - Kurrle, Susan
AU - Campbell, Elissa
AU - Hilgeman, Michelle
AU - Sinclair, Ron
AU - Meller, Anne
AU - Towler, Simon
AU - Edwards, Caroline E.
AU - Comans, Tracy
AU - Sinclair, Craig
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2025/2
Y1 - 2025/2
N2 - Background: Advance care planning (ACP) is potentially helpful for older adults, however, the rate of uptake in community aged care settings is low. Previous pilot studies suggest that holistic, person-centered ACP approaches may be effective for older adults who experience functional impairment but do not necessarily have life-limiting conditions with clear prognoses. This paper describes the protocol of a randomized trial to test the effectiveness of combined life story work and facilitated ACP in promoting ACP engagement among older adults receiving community aged care services. Methods: The Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI) trial is an open-label, cross-over, cluster randomized controlled trial with 12 participating aged care organizations in New South Wales and Western Australia. Participants are aged 65 years or older, receiving home care services and capable of providing informed consent at initial recruitment. Recruitment occurs across a two-year period, with study sites randomized to receive the four-session intervention in the first or second year (or a single session 'active control' condition). Primary outcomes are participant-reported ACP engagement and ACP documentation in the aged care client record 12 weeks post-recruitment. Secondary outcomes include measures of decisional conflict, anxiety and depression, meaning-based coping and relationship quality. Analysis will take an intention-to-treat approach. Conclusion: This trial tests a novel method of reaching older adults using a holistic, person-centered approach to promoting ACP engagement. Enhancing ACP engagement may reduce decisional conflict, minimize hospital admissions and improve outcomes for people and their families. ANZCTR Trial Registration ID: ACTRN12622001399785.
AB - Background: Advance care planning (ACP) is potentially helpful for older adults, however, the rate of uptake in community aged care settings is low. Previous pilot studies suggest that holistic, person-centered ACP approaches may be effective for older adults who experience functional impairment but do not necessarily have life-limiting conditions with clear prognoses. This paper describes the protocol of a randomized trial to test the effectiveness of combined life story work and facilitated ACP in promoting ACP engagement among older adults receiving community aged care services. Methods: The Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI) trial is an open-label, cross-over, cluster randomized controlled trial with 12 participating aged care organizations in New South Wales and Western Australia. Participants are aged 65 years or older, receiving home care services and capable of providing informed consent at initial recruitment. Recruitment occurs across a two-year period, with study sites randomized to receive the four-session intervention in the first or second year (or a single session 'active control' condition). Primary outcomes are participant-reported ACP engagement and ACP documentation in the aged care client record 12 weeks post-recruitment. Secondary outcomes include measures of decisional conflict, anxiety and depression, meaning-based coping and relationship quality. Analysis will take an intention-to-treat approach. Conclusion: This trial tests a novel method of reaching older adults using a holistic, person-centered approach to promoting ACP engagement. Enhancing ACP engagement may reduce decisional conflict, minimize hospital admissions and improve outcomes for people and their families. ANZCTR Trial Registration ID: ACTRN12622001399785.
KW - Advance care planning
KW - Chronic disease
KW - Decisional conflict
KW - Home care
KW - Life story work
KW - Older adults
UR - http://www.scopus.com/inward/record.url?scp=85214202116&partnerID=8YFLogxK
U2 - 10.1016/j.cct.2024.107795
DO - 10.1016/j.cct.2024.107795
M3 - Article
AN - SCOPUS:85214202116
SN - 1551-7144
VL - 149
JO - Contemporary Clinical Trials
JF - Contemporary Clinical Trials
M1 - 107795
ER -