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June 22, 1994

Increasing Completion of Advance Directives-Reply

Author Affiliations

University of California—San Francisco
Kaiser Permanente Medical Center San Francisco, Calif

JAMA. 1994;271(24):1907-1908. doi:10.1001/jama.1994.03510480031025

In Reply.  —Dr Small has suggested that the conclusion that our simple educational intervention increased the completion of durable power of attorney for health care forms is erroneous. In fact, in this randomized, controlled trial, 18.5% of the subjects in the experimental group completed a durable power of attorney for health care form following the receipt of the intervention materials, compared with 0.4% in the control group (P<.0001). Because of the randomized, controlled design of our study, it is unlikely that chance, bias, or temporal trends accounted for our findings. Furthermore, we are confident that this intervention increased the completion of proxy forms and did not, as Small suggested, simply prompt patients to mail in forms that were previously completed and not in their medical records, since the form that patients received was specifically drafted for this study and therefore easily identifiable.Small states that the baseline completion rate

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