Increasing the use of advance directives in medical outpatients

J Gen Intern Med. 1997 Jul;12(7):412-5. doi: 10.1046/j.1525-1497.1997.00072.x.


Objective: We studied whether a simple educational intervention would increase patient completion of advance directives and discussions on end-of-life issues.

Design: Randomized, controlled trial.

Setting: Outpatient clinic of a teaching hospital.

Subjects: One hundred eighty-seven outpatients of a primary care internal medicine clinic.

Intervention: Study subjects attended a 1-hour interactive seminar and received an informational pamphlet and advance directive forms. Control subjects received by mail the pamphlet and forms only.

Measurements and main results: Completion of the advance directive was the main measurement. There were no significant differences in baseline characteristics of either group. Follow-up at 1 month revealed advance directive completion in 38% of study versus 24% of control subjects (p = .04), and discussions on advance planning in 73% of study versus 57% of control subjects (p = .02). Patients most likely to complete the documents were white, married, or attendees at the educational seminar.

Conclusions: Interactive group seminars for medical outpatients increased discussions and use of written advance directives.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Advance Directives / statistics & numerical data*
  • Aged
  • District of Columbia
  • Female
  • Follow-Up Studies
  • Hospitals, Military
  • Humans
  • Living Wills
  • Logistic Models
  • Male
  • Middle Aged
  • Outpatient Clinics, Hospital / statistics & numerical data*
  • Patient Compliance
  • Patient Education as Topic / methods*
  • Physician-Patient Relations
  • Surveys and Questionnaires
  • Truth Disclosure