Default Options in Advance Directives

Status:	Completed
Healthy:	No
Age Range:	18 - Any
Updated:	4/3/2019
Start Date:	January 2014
End Date:	November 2016

In a multicenter, randomized clinical trial of default options in advance directives among
patients with incurable diseases, we will determine whether this simple and readily scalable
intervention can improve patients quality of life and reduce resource utilization without
reducing the number of days that patients are alive and living outside of an acute-care
hospital.

Inclusion Criteria:

- Age 18 or older

- Fluent in English

- Has seen current physician at least once prior to current visit

- Resident of Pennsylvania or New Jersey

- One or more of the following diagnoses:

- Amyotrophic lateral sclerosis

- Stage IIIB or IV non-small cell lung cancer, pancreatic cancer, or cholangiocarcinoma

- Stage IV breast, colon, esophageal, gastric, pancreatic, prostate, uterine, cervical,
ovarian, or urothelial cancer; paraganglioma, or pheochromocytoma

- Stage C or D hepatocellular carcinoma

- Stage IV renal cell carcinoma

- Stage IV or V chronic kidney disease

- Mesothelioma or any malignancy metastatic to the pleura

- Other incurable interstitial lung diseases with at least severe restriction on most
recent pulmonary function tests or eligible for long-term oxygen therapy

- Chronic obstructive pulmonary disease with at least severe airflow obstruction on most
recent spirometry or eligible for long-term oxygen therapy

- Congestive heart failure with NYHA Class IV status or Class III plus 1 heart failure
related hospitalization in the past 12 months or ACC stage D or C classification with
1 heart failure related hospitalization in the past 12 months

Exclusion Criteria:

- Currently listed for or being considered for solid organ transplant

- Patients with a previously signed advance directive or living will.

We found this trial at

sites

University of Pittsburgh Medical Center

200 Lothrop St
Pittsburgh, Pennsylvania 15213