Trial tested effect of advance care planning on family/surrogates' understanding of patients' end-of-life treatment preferences longitudinally. A multisite, assessor-blinded, intent-to-treat, parallel-group, randomized controlled clinical trial in five hospital-based HIV clinics enrolled 449 participants aged 22 to 77 years during October 2013-March 2017. Patients living with HIV/family dyads were randomized at 2:1 ratio to 2 weekly ~ 60-min sessions either ACP (n = 155 dyads)-(1) ACP facilitated conversation, (2) Advance directive completion; or Control (n = 68 dyads)-(1) Developmental/relationship history, (2) Nutrition/exercise tips. ACP families/surrogates were more likely to accurately report patients' treatment preferences at Time 1 (T1) and 12 months post-intervention (T2) compared to controls, experiencing high congruence longitudinally (high→high transition), [63·6% vs 37·7% (difference = 25·9%, 95% CI: 11·3%, 40·4%, χ2 = 11·52, p = 0·01)], even as patients' preferences changed over time. ACP families/surrogates had eight times the odds of controls of having an excellent understanding of patients' treatment preferences (Adjusted Odds Ratio 7.91, 95%CI: 3.08, 20.3). Conversations matter.

中文翻译：

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Family CEntered (FACE®) 预先护理计划对临终治疗偏好纵向一致性的影响：一项随机临床试验。


试验测试了预先护理计划对家人/代理人纵向了解患者临终治疗偏好的影响。 2013 年 10 月至 2017 年 3 月期间，在五家医院 HIV 诊所开展了一项多中心、评估者盲法、意向治疗、平行组、随机对照临床试验，招募了 449 名年龄在 22 岁至 77 岁之间的参与者。 HIV 感染者/家庭二人组患者以 2:1 的比例随机分配至 2 周至 60 分钟的 ACP 课程（n = 155 组）-(1) ACP 促进对话，(2) 完成预先指示；或对照（n = 68 组）-(1) 发展/关系历史，(2) 营养/锻炼技巧。与对照组相比，ACP 家庭/代理人更有可能在时间 1 (T1) 和干预后 12 个月 (T2) 准确报告患者的治疗偏好，经历纵向高度一致性（高→高转变），[63·6% vs 37·7%（差异 = 25·9%，95% CI：11·3%，40·4%，χ2 = 11·52，p = 0·01）]，即使患者的偏好随时间变化。 ACP 家庭/代理人对患者治疗偏好有深入了解的几率是对照组的八倍（调整后优势比 7.91，95%CI：3.08，20.3）。对话很重要。