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 e nd-of-life issues. DESIGN: Randomized, controlled trial. SETTING: Outp atient clinic of a teaching hospital. SUBJECTS: One hundred eighty-sev en outpatients of a primary care internal medicine clinic. INTERVENTIO N: Study subjects attended a 1-hour interactive seminar and received a n informational pamphlet and advance directive forms. Control subjects received by mail the pamphlet and forms only. MEASUREMENTS AND MAIN R ESULTS: Completion of the advance directive was the main measurement. There were no significant differences in baseline characteristics of e ither group, Follow-up at 1 month revealed advance directive completio n in 38% of study versus 24% of control subjects (p = .04), and discus sions on advance planning in 73% of study versus 57% of control subjec ts (p =.02), Patients most likely to complete the documents were white , married, or attendees at the educational seminar. CONCLUSIONS: Inter active group seminars for medical outpatients increased discussions an d use of written advance directives.