Increasing the use of advance directives in medical outpatients.
OBJECTIVE
We studied whether a simple educational intervention would increase patient completion of advance directives and discussions on end-of-life issues.


METHODS
Randomized, controlled trial.


METHODS
Outpatient clinic of a teaching hospital.


METHODS
One hundred eighty-seven outpatients of a primary care internal medicine clinic.


METHODS
Study subjects attended a 1-hour interactive seminar and received an informational pamphlet and advance directive forms. Control subjects received by mail the pamphlet and forms only.


RESULTS
Completion of the advance directive was the main measurement. There were no significant differences in baseline characteristics of either group. Follow-up at 1 month revealed advance directive completion in 38% of study versus 24% of control subjects (p = .04), and discussions on advance planning in 73% of study versus 57% of control subjects (p = .02). Patients most likely to complete the documents were white, married, or attendees at the educational seminar.


CONCLUSIONS
Interactive group seminars for medical outpatients increased discussions and use of written advance directives.
Landry
F J
FJ
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md., USA.
Kroenke
K
K
Lucas
C
C
Reeder
J
J
D000328:Adult; D016223:Advance Directives / Q000706:statistics & numerical data*; D000368:Aged; D004219:District of Columbia; D005260:Female; D005500:Follow-Up Studies; D006772:Hospitals, Military; D006801:Humans; D016224:Living Wills; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014342:Truth Disclosure