University of California medical centers — UCLA Health, UCSF Health and UC Irvine Health — have been awarded a five-year, $8 million award from the Patient-Centered Outcomes Research Institute to develop more effective approaches in advance care planning for seriously ill patients in primary care clinics, UC announced today (April 2).

The prestigious award, one of only seven granted nationally in this area by the pioneering, independent nonprofit research institute, is intended to fund a project that addresses the needs of both patients and caregivers.

Advance care planning is a process involving patients, families and clinicians to foster understanding about illness and prognosis. Such planning can help clarify treatment preferences, identify a decision-making surrogate and develop goals for care during a serious illness and near the end of life.

The three UC medical centers will implement and evaluate three advance care planning approaches that could be eventually carried out in primary care clinics across the nation among people with advanced cancer, heart failure, lung disease and other conditions.

“We are looking for the most effective way of helping patients complete an advance directive, a legal document that spells out their decisions and preferences for medical care,” said Dr. Neil Wenger, a professor of medicine at UCLA and the project’s principal investigator. “This ensures that cutting-edge treatment and therapies will be applied as the patient wishes, with the planning itself often alleviating the stress on loved ones.”

One innovative approach employs a web-based advance care planning tool called “Prepare for Your Care,” created at UCSF Health by Dr. Rebecca Sudore, professor of medicine at UC San Francisco and study investigator. The easy-to-use, culturally appropriate tool empowers people to prepare for decision-making and communication to guide their medical care.

In another approach, facilitators will tee up advance care planning for ready patients to discuss with their physicians. This method grew out of the UCLA Advance Care Planning and Services initiative led by Wenger and Dr. Anne Walling, co-leader of the Patient-Centered Outcomes Research project, who worked closely with Dr. Sam Skootsky, chief medical officer of the UCLA Faculty Practice Group and Medical Group. 

Patients, family members and clinicians will help guide the development and implementation of the approaches in multiple clinics across California. A study advisory committee comprising state and national leaders in advance care planning and palliative care will also play a role, Walling said.

“This demonstrates what can happen when several of our campuses work together to create something in which the total is greater than the sum of the individual contributions,” said Dr. John D. Stobo, the executive vice president of UC Health.

“Conducting this trial will allow us to leverage clinical expertise and advanced technologies for the benefit of patients, who rightfully expect that we precisely target the most advanced medical treatments to meet their health goals and improve their quality of life.”

Other project investigators include UCLA’s Dr. Douglas Bell, Dr. Ron Hays and Dr. Chi-Hong Tseng; Dr. Christine Ritchie of UC San Francisco; and Dr. Lisa Gibbs and Dr. Maryam Rahimi at UC Irvine. The Coalition for Compassionate Care of California, a partnership of leaders from health care, government, consumer groups and the public, will collaborate with UC.

The mission of the Patient-Centered Outcomes Research Institute is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health care decisions.