Study to Identify Patients With Advanced Chronic Conditions in Need of Palliative Care: Validation of the NECPAL Instrument.
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 200
- 试验地点
- 2
- 主要终点
- Proportion of Patients Identified as NECPAL Positive
研究概览
简要总结
Patients with advanced chronic diseases often have complex health needs and may benefit from palliative care. However, many of these patients are not identified early enough to receive appropriate palliative care interventions.
This prospective observational study aims to identify hospitalized patients and patients attending a day hospital with advanced chronic conditions who have palliative care needs, using the NECPAL tool. NECPAL is a validated screening instrument designed to identify patients with advanced chronic diseases who may benefit from palliative care, based on clinical indicators, disease progression, functional decline, and health care utilization.
Adult patients with advanced oncological and non-oncological chronic diseases will be consecutively evaluated. The NECPAL tool will be applied by trained investigators as part of routine clinical assessment. Patients will be classified as NECPAL positive or NECPAL negative according to predefined criteria.
The study will estimate the proportion of patients identified as NECPAL positive, describe their clinical characteristics, and analyze whether they are receiving palliative care. Secondary objectives include comparing clinical variables, comorbidity indices, and mortality between NECPAL-positive and NECPAL-negative patients over follow-up.
The results of this study will provide information on the prevalence of palliative care needs among patients with advanced chronic diseases and support early identification strategies in hospital settings.
详细描述
This is a prospective, observational, analytical study designed to identify patients with advanced chronic conditions who have palliative care needs, using the NECPAL screening tool.
The study will be conducted in hospitalized patients admitted for an acute medical condition and in patients attending a day hospital. Adult patients with at least one advanced chronic oncological or non-oncological disease will be consecutively assessed during routine clinical care.
The NECPAL tool will be applied by trained investigators following the standardized methodology recommended by its developers. The assessment begins with the Surprise Question ("Would you be surprised if this patient died within the next 12 months?"). If the answer is negative, additional clinical indicators related to disease severity, functional decline, comorbidity, symptom burden, and health care utilization are evaluated. Patients will be classified as NECPAL positive or NECPAL negative according to predefined criteria.
For patients identified as NECPAL positive, information regarding current palliative care involvement will be recorded. Clinical, functional, social, and health care utilization variables will be collected from the electronic medical record as part of routine clinical documentation.
Secondary analyses will compare NECPAL-positive and NECPAL-negative patients in terms of comorbidity, functional status, and mortality. Mortality will be assessed during follow-up using hospital records and, when necessary, telephone contact.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
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
- •Adults aged 18 years or older.
- •Hospitalized patients admitted for an acute medical condition or patients attending a day hospital.
- •Presence of at least one advanced chronic oncological or non-oncological disease.
- •Ability to provide informed consent or availability of a legally authorized representative to provide consent.
排除标准
- •Patients in the last days of life at the time of assessment.
- •Patients who die during the acute hospitalization process.
- •Patients with end-stage organ failure who are listed for organ transplantation.
- •Patients with severe psychiatric disease that interferes with study participation.
- •Patients previously included in the study during a prior hospital admission.
- •Patients for whom outpatient follow-up cannot be ensured.
研究组 & 干预措施
Observational Cohort
Adult patients with advanced oncological and non-oncological chronic diseases hospitalized for an acute medical condition or attending a day hospital, assessed using the NECPAL screening tool as part of routine clinical care. No experimental intervention is assigned.
结局指标
主要结局
Proportion of Patients Identified as NECPAL Positive
时间窗: At baseline (at the time of inclusion)
Proportion of adult patients with advanced oncological and non-oncological chronic diseases who are identified as NECPAL positive using the NECPAL screening tool during hospital admission or day hospital assessment.
次要结局
未报告次要终点
研究者
Anabel Franco Moreno
Principal Investigator
Infanta Leonor University Hospital