Study of Home-Embedded Palliative Care for Hemodialysis- (and Peritoneal-) Dependent End-Stage Renal Disease (SHEPHERD 2.0)
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 315
- 试验地点
- 1
- 主要终点
- Acute Encounters
研究概览
简要总结
Home palliative care needs are often under-recognized in patients with End-Stage Renal Disease (ESRD). This pilot study is designed to evaluate the effectiveness of referrals to home palliative care services in improving patient outcomes compared with usual care among patients with ESRD admitted to a Penn hospital. Evaluating the effectiveness of home palliative care services is critical to determine whether increasing access to these services would improve patient-centered outcomes for these high-need patients
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Be an adult (18 years of age or older) hospitalized at a Penn study hospital
- •AND digital signature of ESRD (N18.6) within the last 12 months
- •AND resides in the five-county area surrounding Philadelphia which is served by Penn Palliative Care Nurse Practitioner program
- •AND have one or more of the following markers of potentially unmet needs: (i) existing home care eligibility or referral for home care (but not already receiving PC); (ii) non-ambulatory status determined via nursing assessment; (iii) severe protein-calorie malnutrition; (iv) 2 or more hospitalizations within the prior year
排除标准
- •Patients with functional kidney transplants
- •Patients discharged to skilled nursing facilities and LTC facilities
研究组 & 干预措施
Intervention
The inpatient care team, including the attending/ordering and covering providers, for participants in this group will receive a message from the research team identifying their patient as appropriate for home palliative care and will be asked to refer their patient for these services.
干预措施: Nudge for PHPC NP Referral (Behavioral)
Usual Care
Participants in this group will receive usual care upon discharge from the hospital. Their clinical team will not be notified that they are appropriate for home palliative care services, but they may still be referred for those services if their clinicians feel their patient will benefit.
结局指标
主要结局
Acute Encounters
时间窗: Baseline - 180 days
A combined count of hospitalizations, Emergency Department, and Observation visits during the 180-day follow-up period that will be assessed using the electronic health record and administrative data for the tri-state area
次要结局
- Hospice Enrollment(Baseline - 180 days)
- Symptom Burden(1- and 3-months)
- Hospital-Free Days(Baseline - 180 days)
- Mortality(Baseline - 180 days)
- Quality of Care(1- and 3-months)
- Home Palliative Care Visits(Baseline - 180 days)
- Time to Home Palliative Care Visit(Baseline - 180 days)
- Health-Related Quality of Life(1- and 3-months)
研究者
Scott Halpern
Professor of Medicine
University of Pennsylvania