Using Preanesthesia Clinic Visits to Improve Advance Directives Completion: An Interrupted Time Series Analysis
Main finding · Advance directives completionResult — go to the resultOdds ratio 18 95% CI 16–21Authors' conclusion
Standardizing advance directives discussions during preanesthesia visits was associated with more patients completing advance directives, particularly in vulnerable patient groups.
Study context
- Population
- Adults with >1 comorbidity visiting the Cleveland Clinic preanesthesia clinic before medium- or high-risk noncardiac surgery, January 2015–June 2019visits from 22,430 patients
- Participants
- 26,368 adults
- Comparison
- Postintervention vs preintervention
- Postinterventionn = 15,126
- Preinterventionn = 11,242reference
- Outcome
- Advance directives completion
Methodological detailsbefore-after, single-centre, segmented regression, confounder-adjusted
- Before-after
- Single-centre
- Segmented regression
- Confounder-adjusted
Main finding
As reported in the abstract
Odds ratio
18
95% CI 16–21
P < 0.001
By group
Postintervention vs Preintervention
OR 18 (95% CI 16–21); P < 0.001
Further findings
Completion by race (Black vs White)
- Black patients had lower preintervention completion; gap steadily closed after intervention
- P = 0.001
- No difference in amount of immediate increase
- P = 0.17
- No postintervention change in slope difference
- P = 0.17
Completion by insurance (Medicaid vs private)
- Medicaid lower preintervention; increases in both groups; difference in slopes did not change
- P = 0.43
- Difference in proportions did not change
- P = 0.23
Completion gap by Federal Poverty Line (<100% vs 139%-400%)
- Gap narrowed by approximately half
- 0.51
- 95% CI, 0.27-0.98; P = .04
- Financial status analysed for 16,788 visits from 14,274 patients
Original publication
Using Preanesthesia Clinic Visits to Improve Advance Directives Completion: An Interrupted Time Series Analysis. Anesth Analg. Published 14 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →