OBJECTIVE: To evaluate the Advanced Illness Coordinated Care Program (hereafter AICCP) for effects on health delivery among patients and caregivers, quality of life, advance planning, and health service utilization. STUDY DESIGN: Prospective trial involving 532 patients and 185 caregivers. AICCP consisted of care coordination, health counseling, and education delivered in cooperation with physicians. METHODS: Patients with advanced disease and their caregivers were assigned to AICCP or usual care (UC). Data sources included self-report, medical record review, and health plan databases. Statistical analyses used t test, chi(2) test, regression analysis, and analysis of variance. RESULTS: Compared with those in UC, AICCP participants had improved communication and care concerning symptoms (P = .02), support in understanding and coping with their illness (P = .01), advance planning (P <.001), support in managing family decision making (P = .002), and help in accessing spiritual support (P <.001). AICCP caregivers received more attention for emotional and spiritual needs (P = .02). AICCP participants were 2.23 times more likely to formulate an advance directive (P <.001) (5.5 months sooner [P <.001]) and were 1.26 times more likely to agree to a do-not-resuscitate or do-not-intubate order (P = .04). AICCP participants had on average 1.89 fewer inpatient admissions (P = .045). There was no difference in 1-year survival (P = .80). CONCLUSIONS: AICCP improved communication and care delivery, advance planning, and do-not-resuscitate or do-not-intubate orders in a population at risk to use them. AICCP had fewer admissions. Coordination and health counseling seem matched for those coping with advancing illness.
OBJECTIVE: To evaluate the Advanced Illness Coordinated Care Program (hereafter AICCP) for effects on health delivery among patients and caregivers, quality of life, advance planning, and health service utilization. STUDY DESIGN: Prospective trial involving 532 patients and 185 caregivers. AICCP consisted of care coordination, health counseling, and education delivered in cooperation with physicians. METHODS:Patients with advanced disease and their caregivers were assigned to AICCP or usual care (UC). Data sources included self-report, medical record review, and health plan databases. Statistical analyses used t test, chi(2) test, regression analysis, and analysis of variance. RESULTS: Compared with those in UC, AICCP participants had improved communication and care concerning symptoms (P = .02), support in understanding and coping with their illness (P = .01), advance planning (P <.001), support in managing family decision making (P = .002), and help in accessing spiritual support (P <.001). AICCP caregivers received more attention for emotional and spiritual needs (P = .02). AICCP participants were 2.23 times more likely to formulate an advance directive (P <.001) (5.5 months sooner [P <.001]) and were 1.26 times more likely to agree to a do-not-resuscitate or do-not-intubate order (P = .04). AICCP participants had on average 1.89 fewer inpatient admissions (P = .045). There was no difference in 1-year survival (P = .80). CONCLUSIONS: AICCP improved communication and care delivery, advance planning, and do-not-resuscitate or do-not-intubate orders in a population at risk to use them. AICCP had fewer admissions. Coordination and health counseling seem matched for those coping with advancing illness.
Authors: Adam E Singer; Joy R Goebel; Yan S Kim; Sydney M Dy; Sangeeta C Ahluwalia; Megan Clifford; Elizabeth Dzeng; Claire E O'Hanlon; Aneesa Motala; Anne M Walling; Jaime Goldberg; Daniella Meeker; Claudia Ochotorena; Roberta Shanman; Mike Cui; Karl A Lorenz Journal: J Palliat Med Date: 2016-08-17 Impact factor: 2.947
Authors: Linda C Chyr; Lyndsay DeGroot; Julie M Waldfogel; Susan M Hannum; Danetta H Sloan; Valerie T Cotter; Allen Zhang; JaAlah-Ai Heughan; Renee F Wilson; Karen A Robinson; Sydney M Dy Journal: Ann Fam Med Date: 2022 Jan-Feb Impact factor: 5.707
Authors: Thomas Knight; Alexandra Malyon; Zoe Fritz; Chris Subbe; Tim Cooksley; Mark Holland; Daniel Lasserson Journal: EClinicalMedicine Date: 2020-01-18
Authors: Karen I Connor; Hilary C Siebens; Brian S Mittman; David A Ganz; Frances Barry; Donna K McNeese-Smith; Eric M Cheng; Barbara G Vickrey Journal: BMC Neurol Date: 2022-01-24 Impact factor: 2.474
Authors: Spyros D Mentzelopoulos; Keith Couper; Patrick Van de Voorde; Patrick Druwé; Marieke Blom; Gavin D Perkins; Ileana Lulic; Jana Djakow; Violetta Raffay; Gisela Lilja; Leo Bossaert Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.826