Telemedicine Facilitated Palliative Care Consultations in Rural Dialysis Units
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 39
- 试验地点
- 2
- 主要终点
- Feasibility will be defined as the 1 month completion rate of the consult from time of participant recruitment to the consult.
研究概览
简要总结
Telemedicine (TM) is an innovative approach that has successfully facilitated palliative care consultations (PCC) in rural settings but not yet in dialysis. In this study, the investigators will deliver telemedicine-facilitated PCC to rural dialysis units leveraging an existing telehealth network.
详细描述
Training of dialysis personnel: Dialysis staff will meet with the PI to review eligibility, recruitment and consent during a training meeting prior to beginning recruitment. Overview of the study goals and protocol will also be reviewed at quarterly renal dialysis meetings attended by all nephrologists and dialysis nursing supervisors.
Recruitment and informed consent procedures will occur chairside in the dialysis unit and will be performed by study personnel. Participants will complete a single-item Heard and Understood questionnaire and demographic survey with research personnel.
Consented individuals will be contacted by the research team to schedule an appointment via telemedicine. Scheduling of Telemedicine-palliative care consultation (TM-PCC) will occur as per usual care, based on availability of patient and family, clinician and space, and will be coordinated by study personnel with dialysis staff input. Attention will be paid to travel adjustments as necessary for dialysis patients.
PCC will occur at the dialysis unit. The clinician will be located at UVMMC, at a telemedicine station assigned for this task. The palliative care consult can happen during dialysis and using an iPad and headphones may be worn.
The intervention will occur while on dialysis, unless otherwise requested, using an iPad mounted on a portable stand. Dialysis or research staff will open the Zoom application for the patient and the PCC will occur via Zoom, an encrypted service used by UVMMC already for telemedicine. Headsets will be provided to the patient (and family) to cancel out ambient noise and to enhance privacy. Participants can also choose to have the palliative care consult before or after dialysis, or at home, if they have an internet connection.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
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
- •All patients age 18 and older, receiving maintenance dialysis who are willing and capable of providing informed consent.
排除标准
- •Patients with dementia or other medical conditions that would impair their ability to consent, participate in conversation or complete questionnaires, or patients expected to transfer to a dialysis unit outside of Vermont within 6 months would be excluded.
结局指标
主要结局
Feasibility will be defined as the 1 month completion rate of the consult from time of participant recruitment to the consult.
时间窗: This will be assessed at 18 months.
We will define feasibility as the 1 month completion rate of the consult from time of participant recruitment to the consult.
Acceptability :We will measure acceptability of the telemedicine intervention using a 5-point likert scale.
时间窗: This will be assessed at 18 months.
We will measure acceptability of the telemedicine intervention using a 5-point likert scale.
次要结局
- Quality of communication reported by patients:Quality of communication will be measured using an adapted form of the Quality of Communication survey tool. This consists of 6 questions, each with a score of 0-10.(The survey will be completed within 2 weeks of the intervention.)
- Heard and Understood: Participants will rate on a 5-point scale whether they felt heard and understood during the palliative care consultation.(This question will be completed within 2 weeks of the intervention.)
研究者
Katharine Cheung
Primary Investigator, Assistant Professor of Medicine
University of Vermont