Engagement of Patients With Advanced Cancer
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 213
- 主要终点
- Number of Participants With Completed Goals of Care Documentation. We Will Evaluate if 75% of Patients in the Intervention Arm Have a Documented Goals of Care Titled Medical Note Within 6 Months of Patient Enrollment in the Study.
研究概览
简要总结
The Engagement of Patients with Advanced Cancer is an intervention that utilizes well-trained lay health coaches to engage patients and their families in goals of care and shared decision-making after a diagnosis of advanced cancer. Although lay health workers have never been tested in this role, we hypothesize that lay health workers can feasibly improve goals of care documentation and help to reduce unwanted healthcare utilization at the end of life for Veterans diagnosed with new advanced stages of cancer and those diagnosed with recurrent disease.
详细描述
VAPAHCS proposes to implement and evaluate several critical elements to be in alignment with the VHA's Strategic Goal and priority areas for FY2013. The Engagement of Patients with Advanced Cancer project is an innovative program that will strengthen provider-patient relationship and facilitate whole person care about matters important to Veterans with cancer and important to support network and family. The project is intended to help establish Goals of Care Plan with appropriate documentation, develop, deploy, and evaluate a model of care for persons with cancer that is intended to improve clinical outcomes and experience of care for individuals with advanced cancer who have advanced cancer (stages III, IV or recurrent disease). The intervention provides patients with lay health coaches who assist patients and their families in discussing goals of care and engage in shared-decision making. The goal of the project is to demonstrate that there is improved patient experiences, outcomes, and that the program helps to reduce utilization of health care resources at the end of life.
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
- Single (Investigator)
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
- •Newly diagnosed stage III or IV cancer
- •Recurrent disease (any stage)
- •Ability to consent to study
排除标准
- •Patients who are unable to consent to study procedures
研究组 & 干预措施
A: Intervention Arm
All participants randomized to Arm A will receive the EPAC intervention as well as usual oncologic care.
干预措施: EPAC (Behavioral)
B: Control Group Arm
All participants randomized to Arm B will receive usual oncologic care.
结局指标
主要结局
Number of Participants With Completed Goals of Care Documentation. We Will Evaluate if 75% of Patients in the Intervention Arm Have a Documented Goals of Care Titled Medical Note Within 6 Months of Patient Enrollment in the Study.
时间窗: 6 months after each patient enrollment
Feasibility is defined as at least 75% of patients in the intervention arm with a documented Goals of Care titled medical note within 6 months of patient enrollment in the study.
次要结局
- Change in Patient Satisfaction With Care Using the Consumer Assessment of Health Care Providers and Systems -General Survey(Change in Patient Satisfaction with Care from baseline to 6 months.)
- Hospice Referral (Chart Review)(6 months after patient enrollment)
- Hospitalization Visits (Chart Review)(15 months after patient enrollment)
- Emergency Department Visit (Chart Review)(15 months after patient enrollment)
- Palliative Care Referral (Chart Review)(15 months after patient enrollment)
- Patient Satisfaction With Decision-Making Using the Satisfaction With Decision Survey(6 months)
研究者
Manali Indravadan Patel
Assistant Professor
Stanford University