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Planning Ahead: protocol for a randomised trial of advance care planning for community dwelling older adults at increased mortality risk
Alexia M. Torke, Susan E. Hickman, Lucia D. Wocial, Patrick O. Monahan, Emily S. Burke, James E. Slaven, Kathleen Ziemba, Carole Montgomery et al.. BMJ Open, 2025-05-01
Topic: Risk, prevention and care in population studies
INTRODUCTION: An important goal of advance care planning (ACP) is ensuring that patients receive care concordant with their preferences. High-quality evidence is needed about the effect of ACP on this and other outcomes. METHODS AND ANALYSIS: Planning Ahead is a randomised controlled trial to test the effectiveness of facilitated ACP in community-dwelling older adults including those with normal cognition and those with Alzheimer's Disease and Related Dementias (ADRD) who are at high risk of death. The primary aim is to determine the effect of the intervention on discordance between preferences for medical treatments and the treatments received in the year after the intervention. Secondary outcomes include decision-making quality, care at the end of life and cost. Eligible patients have a primary care provider at one of two Midwest health systems, have an approximate 33% mortality risk and do not have a POLST form at baseline. Patients with capacity can invite the person they would choose to be their healthcare decision maker to participate as a study partner. A surrogate decision maker enrols and receives the intervention for patients who lack capacity due to ADRD. The intervention uses the Respecting Choices Advanced Steps (RCAS) model of ACP delivered by a registered nurse and includes identification of the patient's values and goals, education about ACP and the POLST form and the opportunity to complete a POLST form. ETHICS AND DISSEMINATION: The study is approved by the Indiana University Institutional Review Board. Primary and secondary analyses will be published in peer-reviewed journals. We also plan dissemination through the media. We will construct a deidentified data set that could be available to other researchers. Survey data will be preserved and shared via the NIH-supported National Archive of Computerised Data on Ageing's (NACDA) Open Ageing Repository (OAR). TRIAL REGISTRATION NUMBER: NCT04070183.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Torke, A. M., Hickman, S. E., Wocial, L. D., Monahan, P. O., Burke, E. S., Slaven, J. E., et al. (2025). Planning Ahead: protocol for a randomised trial of advance care planning for community dwelling older adults at increased mortality risk. BMJ Open. https://doi.org/10.1136/bmjopen-2025-102186
Vancouver
Torke AM, Hickman SE, Wocial LD, Monahan PO, Burke ES, Slaven JE, et al. Planning Ahead: protocol for a randomised trial of advance care planning for community dwelling older adults at increased mortality risk. BMJ Open. 2025. doi:10.1136/bmjopen-2025-102186. PMID: 40413042.
BibTeX
@article{torke2025-40413042,
author = {Torke, Alexia M. and Hickman, Susan E. and Wocial, Lucia D. and Monahan, Patrick O. and Burke, Emily S. and Slaven, James E. and Ziemba, Kathleen and Montgomery, Carole and others},
title = {{Planning Ahead: protocol for a randomised trial of advance care planning for community dwelling older adults at increased mortality risk}},
journal = {BMJ Open},
year = {2025},
doi = {10.1136/bmjopen-2025-102186},
pmid = {40413042},
url = {https://doi.org/10.1136/bmjopen-2025-102186}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- ETHICS AND DISSEMINATION: The study is approved by the Indiana University Institutional Review Board.
- Primary and secondary analyses will be published in peer-reviewed journals.
- We also plan dissemination through the media.
- We will construct a deidentified data set that could be available to other researchers.
- Survey data will be preserved and shared via the NIH-supported National Archive of Computerised Data on Ageing's (NACDA) Open Ageing Repository (OAR).
Why it matters
This is a protocol for a randomised controlled trial testing facilitated advance care planning in community-dwelling older adults at high risk of death, including those with Alzheimer's Disease and Related Dementias. It has not yet reported results, so it cannot yet show whether this approach improves care that matches patients' preferences.
Study details
- Study designrandomized controlled trial
- Evidence strengthHigh
How this study scored 54/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size, effect reported and studied in people because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 52 of the 96 points we could judge it on, which is 54 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMJ Open) |
| Journal's citation record | 2 / 4 | BMJ Open: journal h-index 240 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Emily Fox Ludden holds only 6 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 1 / 3 | Michigan State University: institution h-index 1,089 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40413042) |
| Free to read | 2 / 2 | Free to read |
| Points | 52 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 52 of the 96 points we could judge it on is 54 out of 100. |
| Total | 54 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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