NCT02858778Unknown不适用
A Randomized Allocation of Palliative Care Consultation in the Emergency Department Compared to Usual Practice
适应症
试验速览
- 阶段
- 不适用
- 入组人数
- 120
- 试验地点
- 4
- 主要终点
- The difference in the percentage of patients with a completed advance directive (AD) in Ig vs.Cg
研究概览
简要总结
A prospective randomized controlled trial studying the ordering of palliative care consultations in the emergency department (Ig) versus later palliative care consultations in the hospital--ICU or hospital ward(Cg). Patients will be randomly allocated to Ig or Cg with a 1:1 ratio.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Greater than or equal to 65 years old
- •Treated in a resuscitation room for unstable vital signs or respiratory compromise
- •One or more of the following:
- •Advanced or metastatic solid organ cancer
- •End stage organ failure of the heart, lung/COPD, kidney on dialysis, hepatic encephalopathy
- •Suspected sepsis
- •Advanced dementia, end-state multiple sclerosis or Parkinson's disease
- •Status post cardiac arrest with coma (Glascow coma score <7)
- •Patient is from a skilled nursing facility
排除标准
- •Lack decision capacity and have no relative available during ED stay to consent to the study (legally authorized representative-LAR)
- •Enrolled in hospice care prior to randomization
- •A copy of a completed advance directive which names a designated proxy provided physically to the medical team prior to randomization
- •Wearing a DNR bracelet
- •Have been previously enrolled in this study
结局指标
主要结局
The difference in the percentage of patients with a completed advance directive (AD) in Ig vs.Cg
时间窗: 1 year
次要结局
- The proportion of billed CMS ACP-CPT codes in Ig vs. Cg(30 days from enrolled patients' hospital discharge)
- Matches of care received to patient-specific preferences in Ig vs. Cg(1 year)
- Patient/family satisfaction with care in Ig vs. Cg(Baseline)
- Amount of hospice referrals in Ig vs. Cg(1 year)
- Time to consultation in Ig vs. Cg groups(1 year)
- Hospital total direct costs for the index visit in Ig vs. Cg(1 year)
- Hospital and ICU length of stay in Ig vs. Cg(1 year)
- Average days in hospice in Ig vs. Cg(1 year)
- Hospital margin contribution for the index visit in Ig vs. Cg(1 year)
研究者
Robert Zalenski
Principle Investigator
Wayne State University
研究点 (4)
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