Effects of a Transitional Palliative Care Model on Patients With ESRF
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 76
- Locations
- 1
- Primary Endpoint
- Healthcare utilization composite - The dates of re-hospitalizations, length of stay, and number of other hospital services used, including clinics and emergency room visits, will be extracted from the hospital administrative systems.
Study Overview
Brief Summary
Primary aim:
- To compare the effects of customary care and an interventional Home-based Palliative Renal Program (HBPRP) for ESRF patients
- To compare the effects of customary care and Home-based Palliative Program (HBPP) for ESRF patients
Secondary aim: 3. To explore the lived experiences of patients with ESRF. Hypothesis The transitional renal palliative care model is associated with decreased in unscheduled hospital readmission, reduce length of stay as well as improved quality of life for patients with end-stage renal failure.
Detailed Description
Objectives
Related to the primary aim:
- Are there differences in healthcare utilization between the ESRF patients in the customary care group and those in the HBPRP group; in the HBPRP group and HBPP group?
- Are there differences in evaluated health outcomes (functional status, symptom intensity, and satisfaction with care) between the customary care group and the HBPRP group ; in the HBPRP group and HBPP group?
- Are there differences in perceived health outcomes (quality of life, caregiver burden) between the customary care group and the HBPRP group; in the HBPRP group and HBPP group?
Related to the secondary aim: 4. How are the lived experiences compared and contrasted between the customary care group and the HBPRP group; in the HBPRP group and HBPP group?
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patient with chronic kidney disease and diabetic mellitus with Creatinine ≥350 milli mole (uM) or those without diabetic mellitus with Creatinine ≥450 milli mole (uM) who refused renal replacement therapy (RRT);
- •Patient not suitable for long term renal replacement therapy (RRT) after assessment by renal team (e.g. multiple co morbidities, poor functional status and social support)
- •Identified as ESRF patient eligible for palliative care without prior renal replacement therapy
- •Ability to speak Cantonese
- •Living within the hospital service area
- •Ability to be contacted by phone
Exclusion Criteria
- •Discharged to nursing home or other institution
- •Inability to communicate
- •Cognitive impairment, mini mental stage examination (MMSE) < 20
- •Diagnosed with severe psychiatric disorders such as schizophrenia and bipolar disorder
Arms & Interventions
Transitional Palliative Care
Transitional palliative care include:-
- telephone follow up for early identification of signs and symptoms
- home visit for spiritual support
Intervention: Transitional community based palliative care (Behavioral)
Customary care
Customary care receive care :-
- hospital based medical follow up
- general nursing assessment and advice
Outcomes
Primary Outcomes
Healthcare utilization composite - The dates of re-hospitalizations, length of stay, and number of other hospital services used, including clinics and emergency room visits, will be extracted from the hospital administrative systems.
Time Frame: for 12 months
Secondary Outcomes
- Evaluated health outcomes composite (functional status, symptom intensity) - The functional status will be measured by the Palliative Performance Scale (PPS )(appendix 6).(12 months)
Investigators
TAM Mee Ling Bonnie
Clinical Associate
The Hong Kong Polytechnic University