An Inpatient Advance Care Planning Intervention for Older Patients With Hematologic Malignancies

Not Applicable

Completed

• Conditions: Hematologic Malignancies
• Interventions: Behavioral: Inpatient serious illness care program

• Registration Number: NCT05433090
• Lead Sponsor: University of Rochester

Brief Summary

This is a pilot study to assess the preliminary efficacy of an inpatient advance care planning intervention on outcomes in older patients with hematologic malignancies

Detailed Description

Older adults with hematologic malignancies receive more aggressive inpatient care at the end of life compared to patients with solid tumors. Advance care planning may promote early serious illness conversations for patients with hematologic malignancies, leading to less aggressive healthcare utilization at the end of life. This pilot aims to assess the preliminary efficacy of an inpatient advance care planning intervention on outcomes in older patients with hematologic malignancies.

Study Timeline

• Study First Submitted: 2022-06-21
• Study First Submitted QC: 2022-06-21
• Study First Posted: 2022-06-27
• Study Start: 2022-09-06
• Primary Completion: 2024-08-23
• Study Completion: 2024-11-14
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-28
• Last Update Posted: 2025-03-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 88

Inclusion Criteria

• Age ≥60 years
• A diagnosis of hematologic malignancy [including but not limited to acute leukemia, myeloid malignancies (e.g., atypical CML, MDS/MPN overlap syndromes, CMML), multiple myeloma, lymphoma, or any other hematologic malignancies based on the primary oncologist's judgment]
• Able to provide informed consent
• Being managed in the inpatient setting
• English-speaking

Exclusion Criteria

• None

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Experimental	Inpatient serious illness care program	Patients will participate in an inpatient advance care planning intervention.

Primary Outcome Measures

Name	Time	Method
Completion of advance directives	12 weeks	Data on completion of advance directives will be collected via the electronic medical record. This will include explicit statement of the patient's medical preferences for end of life care in a note, scanned medical order for life sustaining treatment (MOLST) form that was completed with their clinician, and/or scanned healthcare proxy form that was completed with their clinician. This will be expressed as a percentage.

Secondary Outcome Measures

Name	Time	Method
End of life quality indicators	Up to 5 years following their participation in the study or death	End of life quality indicators will be extracted from the electronic medical record. These metrics will include hospice enrollment, palliative care referral, chemotherapy administration within the last 2 weeks of life, emergency department visits in the last 30 days of life, intensive care unit admissions in the last 30 days of life, hospitalizations in the last 30 days of life, use of life-sustaining treatments in the last 30 days of life, transfusions in the last 7 days of life, and place of death. These will be expressed as percentages.

Trial Locations

Locations (1)

University of Rochester; 🇺🇸 Rochester, New York, United States