Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital
Introduction Despite the known benefit to patients and families, discussions about goals, values and preferences for medical care in advancing serious illness often do not occur. Many system and clinician factors, such as patient and clinician reticence and shortage of specialty palliative care team...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
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| author | Joshua R Lakin Na Wang Howard J Cabral Michael K Paasche-Orlow Charlotta Lindvall Angelo Volandes Aretha Delight Davis Michael R Winter Edward T Moseley Lori Henault Sophia N Zupanc Sophiya Das Kate Sciacca Edith A Burns Maria T Carney Jennifer Itty Santiago Lopez Kaitlin Emmert Narda J Martin Sherene Lambert Jennifer Polo Shreya Sanghani Julianne N Dugas Michele Gomez Shira Gabry-Kalikow Alexandra Dobie Meredith Amshoff Traci Cucinotta Milton Joel Lisa B Caruso Ana Maria Ramirez Kathleen Salerno Qausarat Ogunneye |
| author_facet | Joshua R Lakin Na Wang Howard J Cabral Michael K Paasche-Orlow Charlotta Lindvall Angelo Volandes Aretha Delight Davis Michael R Winter Edward T Moseley Lori Henault Sophia N Zupanc Sophiya Das Kate Sciacca Edith A Burns Maria T Carney Jennifer Itty Santiago Lopez Kaitlin Emmert Narda J Martin Sherene Lambert Jennifer Polo Shreya Sanghani Julianne N Dugas Michele Gomez Shira Gabry-Kalikow Alexandra Dobie Meredith Amshoff Traci Cucinotta Milton Joel Lisa B Caruso Ana Maria Ramirez Kathleen Salerno Qausarat Ogunneye |
| author_sort | Joshua R Lakin |
| collection | DOAJ |
| description | Introduction Despite the known benefit to patients and families, discussions about goals, values and preferences for medical care in advancing serious illness often do not occur. Many system and clinician factors, such as patient and clinician reticence and shortage of specialty palliative care teams, contribute to this lack of communication. To address this gap, we designed an intervention to promote goals-of-care conversations and palliative care referrals in the hospital setting by using trained palliative care educators and video decision aids. This paper presents the rationale, design and methods for a trial aimed at addressing barriers to goals-of-care conversations for hospitalised adults aged 65 and older and those with Alzheimer’s disease and related Dementias, regardless of age.Methods and analysis The Video Image about Decisions to Improve Ethical Outcomes with Palliative Care Educators is a pragmatic stepped wedge, cluster randomised controlled trial, which aims to improve and extend goals-of-care conversations in the hospital setting with palliative care educators trained in serious illness communication and video decision aids. The primary outcome is the proportion of patients with goals-of-care documentation in the electronic health record. We estimate that over 9000 patients will be included.Ethics and dissemination The Institutional Review Board (IRB) at Boston Medical Center will serve as the single IRB of record for all regulatory and ethical aspects of this trial. BMC Protocol Number: H-41482. Findings will be presented at national meetings and in publications. This trial is registered at ClinicalTrials.gov.Trial registration number NCT04857060; ClinicalTrials.gov |
| format | Article |
| id | doaj-art-0bf5a813a28642c7bbf82418e0c96deb |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-0bf5a813a28642c7bbf82418e0c96deb2025-01-30T14:10:15ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2022-065236Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospitalJoshua R Lakin0Na Wang1Howard J Cabral2Michael K Paasche-Orlow3Charlotta Lindvall4Angelo Volandes5Aretha Delight Davis6Michael R Winter7Edward T Moseley8Lori Henault9Sophia N Zupanc10Sophiya Das11Kate Sciacca12Edith A Burns13Maria T Carney14Jennifer Itty15Santiago Lopez16Kaitlin Emmert17Narda J Martin18Sherene Lambert19Jennifer Polo20Shreya Sanghani21Julianne N Dugas22Michele Gomez23Shira Gabry-Kalikow24Alexandra Dobie25Meredith Amshoff26Traci Cucinotta27Milton Joel28Lisa B Caruso29Ana Maria Ramirez30Kathleen Salerno31Qausarat Ogunneye32Harvard Medical School, Boston, Massachusetts, USA3 Department of Obstetrics, Norinco General Hospital, Xi`an, ChinaDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USABoston University School of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USADepartment of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USAHarvard Medical School, Boston, Massachusetts, USAACP Decisions, Waban, Massachusetts, USABiostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USADepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USABoston University School of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USADepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USADepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USADepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USAInstitute of Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USABiostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USACommonwealth Care Alliance, Boston, Massachusetts, USAACP Decisions, Waban, Massachusetts, USABoston University School of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USAPalliative Medicine, Boston Medical Center, Boston, Massachusetts, USAPalliative Medicine, Boston Medical Center, Boston, Massachusetts, USAPalliative Medicine, Boston Medical Center, Boston, Massachusetts, USABoston University School of Medicine, Department of Medicine, Section of Geriatrics, Boston Medical Center, Boston, Massachusetts, USABoston University School of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USABoston University School of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USABoston University School of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USAIntroduction Despite the known benefit to patients and families, discussions about goals, values and preferences for medical care in advancing serious illness often do not occur. Many system and clinician factors, such as patient and clinician reticence and shortage of specialty palliative care teams, contribute to this lack of communication. To address this gap, we designed an intervention to promote goals-of-care conversations and palliative care referrals in the hospital setting by using trained palliative care educators and video decision aids. This paper presents the rationale, design and methods for a trial aimed at addressing barriers to goals-of-care conversations for hospitalised adults aged 65 and older and those with Alzheimer’s disease and related Dementias, regardless of age.Methods and analysis The Video Image about Decisions to Improve Ethical Outcomes with Palliative Care Educators is a pragmatic stepped wedge, cluster randomised controlled trial, which aims to improve and extend goals-of-care conversations in the hospital setting with palliative care educators trained in serious illness communication and video decision aids. The primary outcome is the proportion of patients with goals-of-care documentation in the electronic health record. We estimate that over 9000 patients will be included.Ethics and dissemination The Institutional Review Board (IRB) at Boston Medical Center will serve as the single IRB of record for all regulatory and ethical aspects of this trial. BMC Protocol Number: H-41482. Findings will be presented at national meetings and in publications. This trial is registered at ClinicalTrials.gov.Trial registration number NCT04857060; ClinicalTrials.govhttps://bmjopen.bmj.com/content/12/7/e065236.full |
| spellingShingle | Joshua R Lakin Na Wang Howard J Cabral Michael K Paasche-Orlow Charlotta Lindvall Angelo Volandes Aretha Delight Davis Michael R Winter Edward T Moseley Lori Henault Sophia N Zupanc Sophiya Das Kate Sciacca Edith A Burns Maria T Carney Jennifer Itty Santiago Lopez Kaitlin Emmert Narda J Martin Sherene Lambert Jennifer Polo Shreya Sanghani Julianne N Dugas Michele Gomez Shira Gabry-Kalikow Alexandra Dobie Meredith Amshoff Traci Cucinotta Milton Joel Lisa B Caruso Ana Maria Ramirez Kathleen Salerno Qausarat Ogunneye Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital BMJ Open |
| title | Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital |
| title_full | Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital |
| title_fullStr | Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital |
| title_full_unstemmed | Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital |
| title_short | Study protocol for Video Images about Decisions to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCE): a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital |
| title_sort | study protocol for video images about decisions to improve ethical outcomes with palliative care educators video pce a pragmatic stepped wedge cluster randomised trial of older patients admitted to the hospital |
| url | https://bmjopen.bmj.com/content/12/7/e065236.full |
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