Patient engagement in advance care planning (ACP) is an important and yet challenging goal for clinicians. Several tradeoffs exist between facilitator-led ACP interventions and their required resources compared with self-administered tools.
A randomized clinical trial led by Yale researchers sought to determine the effect of two clinician-led activities, motivational interviewing (MI) and motivational enhancement therapy, (MET) and one self-administered tool, computer-tailored print feedback (CTPF), on increasing ACP engagement as compared with usual care. Researchers examined the use of different tools in the care of nearly 500 patients at VA Connecticut Healthcare System between 2017 and 2020.
Results showed that MI and MET counseling sessions had a significant impact on engagement in ACP; a series of three MI and MET sessions was associated with a significant increase in the proportion of patients that completed a set of ACP activities. The same association was not found with patients that received the print feedback, suggesting the importance of clinical interaction in the engagement of patients in ACP.