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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.

KEY WORDS: advance directives; living wills.