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Study of Home-Embedded Palliative Care for Hemodialysis- (and Peritoneal-) Dependent End-Stage Renal Disease

Not Applicable
Terminated
Conditions
End-Stage Renal Disease
Interventions
Behavioral: Nudge for PHPC NP Referral
Registration Number
NCT06144281
Lead Sponsor
University of Pennsylvania
Brief Summary

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

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
315
Inclusion Criteria
  • 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
Exclusion Criteria
  • Patients with functional kidney transplants
  • Patients discharged to skilled nursing facilities and LTC facilities

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionNudge for PHPC NP ReferralThe 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.
Primary Outcome Measures
NameTimeMethod
Acute EncountersBaseline - 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

Secondary Outcome Measures
NameTimeMethod
Hospice EnrollmentBaseline - 180 days

New hospice enrollment will be assessed using the electronic health record and administrative data for the tristate area.

Symptom Burden1- and 3-months

Symptom burden will be assessed by the Edmonton Symptom Assessment System survey of patients at 1- and 3-months post-hospital discharge time-points.

Hospital-Free DaysBaseline - 180 days

The number of hospital-free days during the 180-day follow-up period will be assessed using the electronic health record and administrative data for the tri-state area.

MortalityBaseline - 180 days

Mortality rates will be assessed using the electronic health record after the 180-day follow-up period.

Quality of Care1- and 3-months

Quality of care will be assessed by the CMS-MACRA PC Quality Measures (Received Help for Pain; Felt Heard \& Understood) for patients at 1- and 3-months post-hospital discharge time-points.

Home Palliative Care VisitsBaseline - 180 days

The total number of home palliative care visits during the 180-day follow-up period after hospital discharge will be assessed using the electronic health record.

Time to Home Palliative Care VisitBaseline - 180 days

Days from hospital discharge to the first home palliative care visit.

Health-Related Quality of Life1- and 3-months

Health-related quality of life will be assessed by the EQ-5D survey of patients at 1- and 3-months post-hospital discharge time-points.

Trial Locations

Locations (1)

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

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