Educational Intervention Increases Primary Care Providers’ Comfort in Discussing Advance Care Planning

Background: Advances in medicine have made end-of-life difficult for older adults without prior advance care planning (ACP). Benefits of ACP include decreasing family stress, allowing death with dignity and cost saving at end of life. Despite the benefits, less than a third of the population has ACP. Older adults want their primary care provider to initiate conversations on ACP. Primary care providers rate their own comfort level with ACP discussions as low. The purpose of this project was to increase primary health care providers' including Physicians, Nurse Practitioners, and Physician Assistants (PCP) comfort in discussing ACP with their older adult patients. Method: An 8 step educational intervention on best practice for discussing ACP using the Medical Orders for Life Sustaining Treatment (MOLST) Model was conducted in PCP's offices. A convenience sample of 64 primary care providers (PCP) from NYC who care for patients over 65 years of age were surveyed using a descriptive repeated measures design. The pre and posttest instrument is a Communication Strategy Questionnaire for ACP that uses an l4-item Likert scale, with scores ranging from 14-56, measuring comfort in discussing ACP. Results: The MOLST intervention significantly improved comfort in discussing ACP for PCP with their patients (p < 0.001). Conclusion: A simple 8-step educational intervention demonstrates significant improved comfort level amongst PCPs when discussing end-of-life preferences with patients. Primary care providers can make an impact on older adult's end-of-life by discussing advance care planning.