Primary Palliative Care for Emergency Medicine (PRIM-ER)

Emergencies Clinical Trial

Official title:

Primary Palliative Care for Emergency Medicine (PRIM-ER)

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03424109
• Other study ID #: 17-01819
• Secondary ID: 5UH3AT009844
• Status: Active, not recruiting
• Start date: July 1, 2019
• Est. completion date: June 30, 2024

Study information

• Verified date: March 2024
• Source: NYU Langone Health
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This proposal builds upon the evaluation of Primary Palliative Care Education, Training, and Technical Support for Emergency Medicine (PRIM-ER) implemented in 33 Emergency Departments (EDs). This is a retrospective cohort study that seeks to measure the effect of PRIM-ER on older adults with serious illness on aspects of: 1) ED disposition to an acute setting; 2) healthcare utilization in the 6 months following the index ED visit; 3) survival following the index ED visit; and 4) determine site, provider, and patient-level characteristics that are associated with variation in impact of PRIM-ER across sites.

Other known NCT identifiers

• NCT03424096

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 57717
• Est. completion date: June 30, 2024
• Est. primary completion date: June 1, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 66 Years and older

Eligibility

Inclusion Criteria:

• Patients must demonstrate one-year mortality of at least 30 percent (score > 6) according to the Gagne Index, a validated instrument used to measure all cause one-year mortality in community-dwelling older adults, calculated based on their prior 12 months before the index ED visit of Medicare claims.

Exclusion Criteria:

• ED patients transferred from a nursing home on the index ED visit will be excluded since prediction of mortality and disposition of such patients differs from community-dwelling adults.

• Patients currently receiving hospice at the time of the index ED visit will also be excluded since they have already received services.

Related Conditions & MeSH terms

• Emergencies

Intervention

Behavioral:
• healthcare service utilization in the six months following the ED visit
The analysis of the effect of PRIM-ER on ED disposition using a generalized linear binomial model with random site level effects.

Locations

Country	Name	City	State
United States	New York University School of Medicine	New York	New York

Sponsors (4)

Lead Sponsor	Collaborator
NYU Langone Health	Memorial Sloan Kettering Cancer Center, National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Acute care admission	Will be measured on the index ED visit, and will be a dichotomous variable for an acute care admission (Yes/No).	Index Visit
Secondary	ED revisits	Will be measured as the number of ED revisits in the six months following the index ED visit (Count).	6 Months
Secondary	Inpatient days	Will be measured as the number of inpatient stays in the six months following the index ED visit (Count)	6 Months
Secondary	Home health use	Will be measured as a dichotomous variable for any home health use in the six months following the index ED visit (Yes/No)	6 Months
Secondary	Hospice use	Will be measured as a dichotomous variable for any hospice use in the six months following the index ED visit (Yes/No)	6 Months
Secondary	Survival	Will be measured as a dichotomous variable for death in the six months following the index ED visit (Yes/No)	6 Months
Secondary	Survival: Time-to-event	Will be measured as the number of days from index ED visit to death among those who died within six months following the index ED visit (Count of days)	6 Months