Use of chart reminders for physicians to promote discussion of advance directives in patients with AIDS.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Use of chart reminders for physicians to promote discussion of advance directives in patients with AIDS.

AIDS Care. 1999 Jun;11(3):345-53. Unique Identifier : AIDSLINE MED/99403880
Walker NM; Mandell KL; Tsevat J; Department of Internal Medicine, University of Cincinnati Medical; Center, Ohio 45267-0535, USA.

Abstract: To determine if use of a physician chart reminder improves the rate of physician-initiated discussion and subsequent completion of advance directives (ADs) in patients with AIDS, a controlled study was conducted with 74 patients with AIDS and ten physicians providing primary care at a university-based hospital clinic. Chart reminders were placed on medical records of intervention patients at each primary care clinic visit for six months. Twelve out of 39 (31%) reminder group patients, but only three out of 35 (9%, p = 0.02) control patients underwent AD discussion with physicians. Further, more subjects in the reminder group completed ADs (28% versus 9%, p = 0.03). Controlling for demographic and clinical factors, only assignment to reminder group was associated with discussion and completion of ADs. Physician-level analysis showed that the effect was physician-dependent. Physician chart reminders are an effective tool for promoting discussion and completion of ADs in patients with AIDS although the effect is physician-dependent.

Keywords: JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/*PSYCHOLOGY Adult *Advance Directives Case-Control Studies Health Promotion Human Medical Records Medical Staff, Hospital Primary Health Care *Reminder Systems
991230
A99C1052

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