O-85 Advance care planning and decisional conflict in adolescents with HIV

Background

Advance care planning (ACP) may decrease decisional conflict and better prepare patients for future healthcare decisions.

Aim

Examine effects of an ACP intervention on decisional conflict.

Methods

Data were collected from 94 HIV positive adolescents in the FAmily-Centred (FACE) ACP trial from five hospital-based clinics. Participants were randomised to FACE (n = 47) or Healthy Living Control (HLC) (n = 47), each consisting of three 60 min sessions. Participants completed the Decisional Conflict Scale (DCS) immediately following intervention (Time 1) and 3 months post-intervention (Time 2). DCS yields Total and five subscale scores (Means ≥2.5 indicates high decisional conflict; range 1–5). Generalised Estimating Equations (GEE) examined intervention effects controlling for age, gender, and race.

Results

Adolescents were: mean age 18 years (range 14–20); 47% female; 93% African-American. Total decisional conflict and subscales scores were not significantly different between groups regardless of time; nor did scores change significantly over time (Means: Time 1 FACE 1.95 vs. HLC 1.92; Time 2 FACE 2.11 vs. HLC 1.93). African-Americans had higher Total score and Unsupported score vs. non-African-Americans, regardless of time [(Total: slope = 0.2517, p = 0.0075; Means: Time 1 1.94 vs. 1.80, Time 2 2.04 vs. 1.70); (Unsupported: slope = 0. 7502, p = <0.0001; Means: Time 1 2.20 vs. 1.38, Time 2 2.31 vs. 1.74)]. Males had higher Uninformed score vs. females, regardless of time (Uninformed: slope = 0.3094, p = 0.0126; Means: Time 1 1.89 vs. 1.43, Time 2 1.81 vs. 1.68).

Discussion/conclusion

Results differ from previous ACP studies. Decisional conflict was low overall with no significant intervention effect; rather, demographic variables were more influential.