A Randomized Controlled Trial of a CPR Decision Support Video for Patients Admitted to the General Medicine Service

J Hosp Med. 2017 Sep;12(9):700-704. doi: 10.12788/jhm.2791.

Abstract

Background: Patient preferences regarding cardiopulmonary resuscitation (CPR) are important, especially during hospitalization when a patient's health is changing. Yet many patients are not adequately informed or involved in the decision-making process.

Objective: We examined the effect of an informational video about CPR on hospitalized patients' code status choices.

Design: This was a prospective, randomized trial conducted at the Minneapolis Veterans Affairs Health Care System in Minnesota.

Participants: We enrolled 119 patients, hospitalized on the general medicine service, and at least 65 years old. The majority were men (97%) with a mean age of 75.

Intervention: A video described code status choices: full code (CPR and intubation if required), do not resuscitate (DNR), and do not resuscitate/do not intubate (DNR/DNI). Participants were randomized to watch the video (n = 59) or usual care (n = 60).

Measurements: The primary outcome was participants' code status preferences. Secondary outcomes included a questionnaire designed to evaluate participants' trust in their healthcare team and knowledge and perceptions about CPR.

Results: Participants who viewed the video were less likely to choose full code (37%) compared to participants in the usual care group (71%) and more likely to choose DNR/DNI (56% in the video group vs. 17% in the control group) (𝑃 < 0.00001). We did not see a difference in trust in their healthcare team or knowledge and perceptions about CPR as assessed by our questionnaire.

Conclusions: Hospitalized patients who watched a video about CPR and code status choices were less likely to choose full code and more likely to choose DNR/DNI.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cardiopulmonary Resuscitation*
  • Critical Illness*
  • Decision Making*
  • Decision Support Systems, Clinical
  • Female
  • Hospitalization
  • Hospitals, Veterans
  • Humans
  • Male
  • Minnesota
  • Patient Preference / psychology*
  • Prospective Studies
  • Videotape Recording*