Abstract

OBJECTIVE:

To test the efficacy of two intervention methods that aimed to increase the percentage of adult clinic patients who completed living wills and placed them on file with their physicians within a four-month period.

DESIGN:

There were one control and two intervention groups. Surveys were separated by age and gender categories and randomly selected for the final sample.

SETTING:

The internal medicine outpatient clinic of a large tertiary hospital.

PARTICIPANTS:

All patients who visited the clinic were asked whether they would be willing to fill out a survey. The final sample included 167 adult patients who comprised three study groups.

INTERVENTIONS:

The first intervention relied solely on a booklet that described the Minnesota Living Will Act, general information concerning advance directives, and medical interventions that could be considered extraordinary if used for a patient in a terminal condition. The second intervention relied on both the booklet and repeated physician-initiated discussions with the patient about the probable value of a living will.

MAIN RESULTS:

The booklet/physician intervention was found to be significantly more effective than either the booklet-only intervention or no intervention (p less than 0.05 and 0.01, respectively).

CONCLUSIONS:

The physician intervention used in this population could be undertaken in any primary care clinic. Time spent in discussion before a crisis may be significantly shorter and qualitatively better than time spent in discussion with families who must make decisions during a crisis.