The COAST project: Introducing and implementing a transferable, readily accessible, and actionable end of life planning tool for patients with advanced serious illness or frailty in southern New Zealand.
- Conditions
- CancerCardiovascular diseaseDementiaRespiratory diseaseCancer - Any cancerTerminal illnessAdvanced and progressive frailtyCardiovascular - Coronary heart diseaseNeurological - DementiasNeurological - Neurodegenerative diseases
- Registration Number
- ACTRN12619000627156
- Lead Sponsor
- Hospice Southland
- Brief Summary
The purpose of this study was to see if a newly-created one page "COAST" form used to record treatment plans for seriously ill or very frail patients in Southland is acceptable to patients, families, and health providers and to determine whether using this new form reduces hospitalisations. Prior to introducing "COAST", each health facility had its own form that was used to record patient treatment plans. During the 9-month trial period, 183 people were included in the research study. Half of the people were men and half were women. The average age was 73.9 years old. Most patients were of NZ European ethnicity and 7.1% were Maori. Over half of patients had a cancer diagnosis, but 42% did not have cancer. 72% lived in the community and the remained lived in rest homes or supported accommodation. 37 surveys were returned from patients or their next of kin, with 81% reporting the COAST form was explained well and over half believing that COAST would improve the person's care. 6 doctors responded to the survey about their experience with COAST; all believed they had received adequate training and education about the COAST form. None of the doctors felt COAST harmed patient care and comments were that the COAST form was clear, easy to use, and concise. A lack of time to have discussions and not being sure about prognosis were identified barriers to completing COAST. Data about hospitalization rates before and after COAST forms were completed is still being analysed.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 183
All adults aged 18 years and older in their final year of life assessed by one of the following criteria: Advanced progressive illness and/or frailty as identified by a doctor or nurse practitioner for whom the clinician answers no” to the Surprise Question: Would you be surprised if this patient died in the next 12 months?”, or referral for specialist palliative care services through Hospice Southland or the hospital-based Palliative Care Advisory Service.
Patient does not reside in Southland
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method The primary aim of the study will be to evaluate if the introduction of the document in southern New Zealand reduces hospitalisations for patients in their final year of life. Audit of number of emergency department presentations and hospitalisations in the 12 months preceding study enrolment, and 12 months after study enrolment, using Health Connect South.<br>[12 months after COAST form initiated]
- Secondary Outcome Measures
Name Time Method The secondary aim of the study will be to assess the acceptability of the document from healthcare professionals involved in its use.<br><br>A survey will be distributed at the end of each implementation phase to address the secondary aim; investigating satisfaction of health practitioners with the COAST form and process, and any enablers or barriers to completion. Survey designed specifically for this study.[End of 9 month pilot];The secondary aim of the study will be to assess the acceptability of the document to patients and/or their proxy.<br><br>Patients will be given a survey to complete following completion of the COAST process , along with a postage-prepaid return envelope. Survey designed specifically for this study.[End of 9 month pilot]