OP26 Effects of a late life supportive care innovation that focuses on what matters most

2019 
Background Whole person care is a new paradigm for serious illness beyond disease specific practice guidelines and lacks robust evaluation. The purpose of this presentation is to describe the effects of LifeCourse(LC), a person-centered program for patients living with serious illness, utilization of healthcare, care experience and quality of life. Methods This quasi-experimental intervention study with a Usual Care (UC) comparison group was conducted between 2012–2017. Enrolled patients (N=903) were estimated to be within 3 years of end of life and diagnosed with 1+ serious illness. Community health workers (CHWs) delivered standardized monthly 1-hour home visits based on palliative care guidelines to assist patients in identifying self-defined goals, support ongoing person-centered advance care planning, and promote physical, psychosocial and financial wellbeing. Primary outcomes included healthcare utilization measured by electronic health records and patient and caregiver-reported experience and quality of life measured every 3 months. Results Patients were elderly (LC 74, UC 78 years) and primarily non-Hispanic, white, living at home, and had a cardiovascular primary diagnosis (LC 69%, UC 57%). A higher proportion of LC patients completed advance directives during the study (N=173, 38%) than did UC patients (N=66, 15%; p Conclusions The implementation of person-centered programs delivered by CHWs is feasible. Inexpensive upstream expansion of palliative care models can yield benefits for patients and caregivers.
    • Correction
    • Source
    • Cite
    • Save
    • Machine Reading By IdeaReader
    0
    References
    0
    Citations
    NaN
    KQI
    []