NCT06090552

I CAN DO Surgical ACP

I CAN DO Surgical ACP (Improving Completion, Accuracy, and Dissemination of Surgical Advanced Care Planning) Trial

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 6,000 (estimated)
• Sponsor: University of California, San Francisco · Academic / Other
• Sex: All
• Age: 65 Years
• Healthy volunteers: Not accepted

Summary

The goal of the Advanced Care Planning (ACP) study is to encourage patients aged 65 or older who are referred for elective surgery to have advanced care planning.

Detailed description

ACP is also a critical way to support older adults in participating actively with clinicians in making real-time, complex medical decisions so that the medical care they receive is aligned with their goals. Our team has designed and tested a theory-based, interactive ACP patient-facing technology solution (PREPARE) based on the new ACP paradigm of preparing people for communication and medical decision-making. The study team hypothesizes that by including PREPARE into the EHR-centric pre-surgery workflow for older adults and including automated patient reminders, easy-to-read materials, and, in Arm 3, directed support from a healthcare navigator (HCN), they can empower patients and surgical teams to engage in ACP discussions. They also hypothesize that ACP documentation will increase more with increasing resource intensity (i.e., Arm 3 more than Arm 2 more than Arm 1). Participants will be randomized to Arms: (1) Letter about ACP, PREPARE advanced directive (AD), PREPARE website; (2) Letter, advanced directive (AD), PREPARE plus reminder messages; (3) Letter, advanced directive (AD,) PREPARE plus reminders plus a healthcare navigator on ACP documentation (clinically meaningful ACP, primary outcome). All patients randomized to the intervention will be sent a patient-reported ACP engagement survey (secondary outcome).

Conditions

• Surgical Advanced Care Planning

Interventions

Type	Name	Description
BEHAVIORAL	Letter	Letter about ACP
BEHAVIORAL	AD	PREPARE advanced directive (AD)
BEHAVIORAL	PREPARE website	PREPARE website
BEHAVIORAL	reminders	reminders to complete the advance directive
BEHAVIORAL	healthcare navigator	healthcare navigators provide assistance to complete the advance directive

Timeline

• Start date: 2025-02-26
• Primary completion: 2028-08-31
• Completion: 2028-08-31
• First posted: 2023-10-19
• Last updated: 2025-08-06

Locations

3 sites across 1 country: United States