Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness
Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case m...
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2019-01-01
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| author | Jeanne Cho Michael Hill Corita R Grudzen Deborah J Shim Abigail M Schmucker Keith S Goldfeld Lauren Southerland Jeffrey M Caterino Marie-Carmelle Elie Robert Swor Susan E Cohen Arum Kim Joseph Lowy Jennifer S Scherer Nancy E Bael Ellin Gafford Joshua Lakin Paige Barker Angela Chmielewski Jennifer Kapo Audrey Tan Rebecca Yamarik Susan Salz Stephen Ryan Anne Kim Isabel Castro Amelia Hargrove Laura Stuecher Nora Daut Juanita Booker-Vaughns Garrett K Chan J Nicholas Dionne-odom Patrick Dunn Robert Galvin Ernest A Hopkins III Margaret M Maguire Neha Reddy Pidatala Dawn Rosini Sally Welsh Karen Jubanyik Ada L Rubin Kei Ouchi Rebecca Murray Nicole Tang Marie Bakitas Abraham Brody Caroline Blaum Mara Flannery Richard Tamirian Pamela Marsack Jennifer Bonito Romilla Batra Donna C Sadasivan Eric David Isaacs Constance L Kizzie-Gillett William K Vaughan Pluscedia G Williams Angela Young-Brinn |
| author_facet | Jeanne Cho Michael Hill Corita R Grudzen Deborah J Shim Abigail M Schmucker Keith S Goldfeld Lauren Southerland Jeffrey M Caterino Marie-Carmelle Elie Robert Swor Susan E Cohen Arum Kim Joseph Lowy Jennifer S Scherer Nancy E Bael Ellin Gafford Joshua Lakin Paige Barker Angela Chmielewski Jennifer Kapo Audrey Tan Rebecca Yamarik Susan Salz Stephen Ryan Anne Kim Isabel Castro Amelia Hargrove Laura Stuecher Nora Daut Juanita Booker-Vaughns Garrett K Chan J Nicholas Dionne-odom Patrick Dunn Robert Galvin Ernest A Hopkins III Margaret M Maguire Neha Reddy Pidatala Dawn Rosini Sally Welsh Karen Jubanyik Ada L Rubin Kei Ouchi Rebecca Murray Nicole Tang Marie Bakitas Abraham Brody Caroline Blaum Mara Flannery Richard Tamirian Pamela Marsack Jennifer Bonito Romilla Batra Donna C Sadasivan Eric David Isaacs Constance L Kizzie-Gillett William K Vaughan Pluscedia G Williams Angela Young-Brinn |
| collection | DOAJ |
| description | Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and dissemination Institutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration number NCT03325985; Pre-results. |
| format | Article |
| id | doaj-art-faac1fd9016641148e84fb49b1846619 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-faac1fd9016641148e84fb49b18466192025-02-11T21:40:10ZengBMJ Publishing GroupBMJ Open2044-60552019-01-019110.1136/bmjopen-2018-025692Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness 0Jeanne Cho1Michael Hill2Corita R Grudzen3Deborah J Shim4Abigail M Schmucker5Keith S Goldfeld6Lauren Southerland7Jeffrey M CaterinoMarie-Carmelle ElieRobert SworSusan E CohenArum KimJoseph LowyJennifer S SchererNancy E BaelEllin GaffordJoshua LakinPaige BarkerAngela ChmielewskiJennifer Kapo8Audrey Tan9Rebecca YamarikSusan SalzStephen RyanAnne KimIsabel Castro10Amelia HargroveLaura StuecherNora DautJuanita Booker-VaughnsGarrett K Chan11J Nicholas Dionne-odom12Patrick DunnRobert GalvinErnest A Hopkins IIIMargaret M MaguireNeha Reddy PidatalaDawn RosiniSally WelshKaren JubanyikAda L Rubin13Kei Ouchi14Rebecca Murray15Nicole Tang16Marie Bakitas17Abraham BrodyCaroline BlaumMara FlanneryRichard TamirianPamela MarsackJennifer BonitoRomilla BatraDonna C SadasivanEric David IsaacsConstance L Kizzie-GillettWilliam K VaughanPluscedia G WilliamsAngela Young-BrinnKenya National Bureau of Statistics, Nairobi, Nairobi, Kenya7 Sala Institute for Child and Family Centered Care at NYU Langone Health, New York City, New York, USA13University of Calgary; National Coordinating Center Canada1 Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York City, New York, USA2 Augusta University Medical College of Georgia, Augusta, Georgia, USA3 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA2 Department of Population Health, New York University School of Medicine, New York City, New York, USADepartment of Emergency Medicine, Ohio State University, Columbus, Ohio, USAYale School of Medicine, Yale University, New Haven, Connecticut, USA1 Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York City, New York, USA4Departamento Tecnología Médica, Universidad de Chile, Santiago, Chile1Stanford Healthcare, Stanford, California, USA4 School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA1 Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York City, New York, USADepartment of Emergency Medicine, Brigham and Women`s Hospital, Boston, Massachusetts, USA3 Patient Partner with the OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, USASchool of Nursing, The University of Alabama, Birmingham, Alabama, USAIntroduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and dissemination Institutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration number NCT03325985; Pre-results.https://bmjopen.bmj.com/content/9/1/e025692.full |
| spellingShingle | Jeanne Cho Michael Hill Corita R Grudzen Deborah J Shim Abigail M Schmucker Keith S Goldfeld Lauren Southerland Jeffrey M Caterino Marie-Carmelle Elie Robert Swor Susan E Cohen Arum Kim Joseph Lowy Jennifer S Scherer Nancy E Bael Ellin Gafford Joshua Lakin Paige Barker Angela Chmielewski Jennifer Kapo Audrey Tan Rebecca Yamarik Susan Salz Stephen Ryan Anne Kim Isabel Castro Amelia Hargrove Laura Stuecher Nora Daut Juanita Booker-Vaughns Garrett K Chan J Nicholas Dionne-odom Patrick Dunn Robert Galvin Ernest A Hopkins III Margaret M Maguire Neha Reddy Pidatala Dawn Rosini Sally Welsh Karen Jubanyik Ada L Rubin Kei Ouchi Rebecca Murray Nicole Tang Marie Bakitas Abraham Brody Caroline Blaum Mara Flannery Richard Tamirian Pamela Marsack Jennifer Bonito Romilla Batra Donna C Sadasivan Eric David Isaacs Constance L Kizzie-Gillett William K Vaughan Pluscedia G Williams Angela Young-Brinn Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness BMJ Open |
| title | Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness |
| title_full | Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness |
| title_fullStr | Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness |
| title_full_unstemmed | Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness |
| title_short | Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness |
| title_sort | emergency medicine palliative care access empalla protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse led telephonic palliative care of older adults with advanced illness |
| url | https://bmjopen.bmj.com/content/9/1/e025692.full |
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