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Welcome to the Meta-larc advance care planning trial

What Matters

Understanding what is most important to primary care patients who are seriously ill.

When facing serious illness, people often have to make many decisions about tests and treatments. The crucial first step in assuring healthcare supports quality of life and well-being is talking about what matters most. Advance care planning is the process of having these conversations and making sure preferences are known and healthcare supports patient goals. We conducted a research study on how to make sure advance care planning happens in primary care: where most people get most of their care most of the time.

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The Meta-LARC ACP Trial

  • Meta-LARC is a consortium of seven Practice-based Research Networks in the United States and Canada. Includes over 900 primary care practices and approximately 4,000 clinicians, who care for over 3 million patients located in rural, urban, and underserved communities. Learn more about Who We Are.

  • An important aspect of this project is Engagement. We worked with patients and families, primary care clinicians and staff, and other stakeholders interested in advance care planning to improve the trial and make sure what we learn is useful to others. Learn more about our work with Engagement.

  • Our trial used the Serious Illness Care Program (SICP), an advance care planning program developed by Ariadne Labs.

  • This trial is funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Award (PLC-1609-36277).

  • We are currently working on the results from the trial and sharing what we have learned. We will be adding trial results as soon as July 2022.

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Why Study Advance Care Planning?

Most people say they want to talk about what they value and that sharing their preferences is important. But only a small percentage of people have talked to their doctor, any clinician, or their family. Even fewer have put their goals and values in writing.

Primary care practices often have long-standing relationships with their patients and want to have conversations with patients about their goals and make sure patients’ wishes are honored. But primary care practices are busy and advance care planning does not always happen.

Everyone agrees that it is better to talk and make plans before there is a crisis. Our goal is to make advance care planning routine in primary care and to “move it upstream” so that it includes improving the quality of the last years of life as well respecting wishes for end of life care.

 
 

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“I realized that by talking not only to the people in this group, to my friends and people I happen to run into while talking about this project, how few people actually know what ACP is and how important it is. And they really don’t know how to go about dealing with it.

I was talking about this with other grandmothers at my grandchild’s activity, and she was asking what should I do, should I write a letter and put it in my night table?

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Source: Patient-Family Advisor reflecting on their experience with the trial

 

 
 

Our Reach

Our goal is to make advance care planning routine in primary care. We want more patients to experience the best quality of life possible despite their serious illness. We want healthcare to be a positive force that supports the goals and honors the preferences of patients. This is why we are conducting a large trial in several different locations.

 

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Practice based Research Networks

The seven networks are located in five U.S. States and two Canadian Provinces. Visit Who We Are for details.

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Primary Care Practices

The practices that participated in the trial are rural and urban, small and large, independent and part of health systems. This diversity enables our findings to be useful to a range of practices.

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Patients and Care Partners

Our target was to enroll over one thousand patients or the person who helps them with their care, a “care partner”. Their willingness to answer questions and share their experience made this trial possible and will hopefully help improve care for many more people.

 
 

Stay In Touch

We want to share our progress with the trial and experience implementing advance care planning in primary care. And we would like to hear about your efforts, personal or professional, related to advance care planning. You can use the CONTACT link to send us an email with a specific comment, story, or question.

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