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.