proactieve zorgplanning in de huisartspraktijk bij mensen met dementie en hun naasten

Rationale: Communicating with persons with dementia about current and future care may require specific skills. ACP facilitates decision-making and may increase control over care and treatment at the end of life. Since it is advised to start ACP early in case of dementia, GPs are well positioned to initiate ACP. There are different approaches to ACP, and up until now, there is lack of research on the effect of different ACP approaches.
Objective: We aim to assess the effects of two approaches of ACP (detailed advance treatment orders versus global goal setting and coping based) on wellbeing of persons with dementia. In addition, we will assess effects on decisional conflict, self-efficacy to interact with physicians, and family caregiver perception of physician-family caregiver communication.
Study design: a 3-armed cluster-randomized controlled trial, with a duration of 3 years.
Study population: GPs, persons with dementia with decisional capacity, and their family caregivers.
Intervention: Both interventions include multiple interactive training sessions, forms to document results of ACP, and prompting of persons with dementia and their family caregiver by providing a question prompt list on palliative care in dementia. The contents of the training, forms and question prompt lists match the focus of the respective intervention.
Main study parameters/endpoints: The main outcome is wellbeing of persons with dementia. The secondary outcomes are decisional conflict, self-efficacy to interact with physicians, and family caregiver perception of physician-family caregiver communication.