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This trial aims to find if the use of the Advance Directives documents as a communication tool, improves the agreement between patients and caregivers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This trial occurred in a palliative care service of a Portuguese hospital center. A prospective, single-blinded, controlled, randomized trial, enrolling patients and caregivers as a dyad was conducted. Participants individually fulfilled an Advance Directive document, in which patients reported their end-of-life preferences and caregivers reported their decisions as patients\u2019 health surrogates. Dyads were randomly assigned to the Intervention or the Control group, in which the physician respectively promoted an open discussion about patients\u2019 Advance Directives or evaluated patients\u2019 clinical condition. Caregivers\u2019 Advance Directives as surrogates were collected one month later. Proportions of agreement and Cohen\u2019s \u03ba were used to access agreement and reliability, respectively, between the dyads.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results from 58 dyads were analyzed. We observed an improvement in agreement between the caregivers\u2019 answers and the patients\u2019 wishes on two-thirds (8\/12) of the answers, in the Intervention group, contrasting to one-quarter (3\/12) of the answers, in the Control group, despite statistical significance in differences wasn\u00b4t obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although not reaching statistical significance, the results suggest that discussions of advance directives with physicians may lead to better prepared surrogates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>ClinicalTrials.gov ID<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT05090072?term=NCT05090072&amp;cond=Advance+Directives&amp;draw=2&amp;rank=1\">NCT05090072<\/jats:ext-link>. Retrospectively registered on 22\/10\/2021.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12904-022-01013-3","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T21:12:04Z","timestamp":1657660324000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Do surrogates predict patient preferences more accurately after a physician-led discussion about advance directives? A randomized controlled trial"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4505-1608","authenticated-orcid":false,"given":"Catarina Sampaio","family":"Martins","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5436-4155","authenticated-orcid":false,"given":"Iva","family":"Sousa","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5281-1188","authenticated-orcid":false,"given":"Cl\u00e1udia","family":"Barros","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0624-5538","authenticated-orcid":false,"given":"Alexandra","family":"Pires","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1312-0154","authenticated-orcid":false,"given":"Luisa","family":"Castro","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7109-1101","authenticated-orcid":false,"given":"Cristina","family":"da Costa Santos","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1377-9899","authenticated-orcid":false,"given":"Rui","family":"Nunes","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"issue":"2","key":"1013_CR1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1086\/JCE201324204","volume":"24","author":"AR Wittich","year":"2013","unstructured":"Wittich AR, Williams BR, Bailey FA, Woodby LL, Burgio KL. \u201cHe got his last wishes\u201d: Ways of knowing a loved one\u2019s end-of-life preferences and whether those preferences were honored. 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