An Inpatient Advance Care Planning Intervention for Older Patients With Hematologic Malignancies

Hematologic Malignancies Clinical Trial

— APP SICP  

Official title:

An Inpatient Advance Care Planning Intervention for Older Patients With Hematologic Malignancies

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05433090
• Other study ID #: UOCPC22039
• Status: Recruiting
• Phase: N/A
• Start date: September 6, 2022
• Est. completion date: November 1, 2024

Study information

• Verified date: June 2023
• Source: University of Rochester
• Contact: Kah Poh Loh
• Phone: 585-275-4401
• Email: kahpoh_loh[@]urmc.rochester.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a pilot study to assess the preliminary efficacy of an inpatient advance care planning intervention on outcomes in older patients with hematologic malignancies

Description:

Older adults with hematologic malignancies receive more aggressive inpatient care at the end of life compared to patients with solid tumors. Advance care planning may promote early serious illness conversations for patients with hematologic malignancies, leading to less aggressive healthcare utilization at the end of life. This pilot aims to assess the preliminary efficacy of an inpatient advance care planning intervention on outcomes in older patients with hematologic malignancies.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: November 1, 2024
• Est. primary completion date: November 1, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 60 Years and older

Eligibility

Inclusion Criteria:

• Age =60 years
• A diagnosis of hematologic malignancy [including but not limited to acute leukemia, myeloid malignancies (e.g., atypical CML, MDS/MPN overlap syndromes, CMML), multiple myeloma, lymphoma, or any other hematologic malignancies based on the primary oncologist's judgment]
• Able to provide informed consent
• Being managed in the inpatient setting
• English-speaking

Exclusion Criteria:

• None

Related Conditions & MeSH terms

• Hematologic Malignancies
• Hematologic Neoplasms
• Neoplasms

Intervention

Behavioral:
• Inpatient serious illness care program
Inpatient advance care planning intervention that will be delivered by advanced care practitioners or hematology/oncology fellow physicians. The intervention will be an adapted version of the serious illness care program.

Locations

Country	Name	City	State
United States	University of Rochester	Rochester	New York

Sponsors (1)

Lead Sponsor	Collaborator
University of Rochester

Country where clinical trial is conducted

United States, 

References & Publications (1)

LoCastro M, Baran AM, Liesveld JL, Huselton E, Becker MW, O'Dwyer KM, Aljitawi OS, Baumgart M, Snyder E, Kluger B, Loh KP, Mendler JH. Portable medical orders and end-of-life measures in acute myeloid leukemia and myelodysplastic syndromes. Blood Adv. 2021 Dec 28;5(24):5554-5564. doi: 10.1182/bloodadvances.2021004775. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Completion of advance directives	Data on completion of advance directives will be collected via the electronic medical record. This will include explicit statement of the patient's medical preferences for end of life care in a note, scanned medical order for life sustaining treatment (MOLST) form that was completed with their clinician, and/or scanned healthcare proxy form that was completed with their clinician. This will be expressed as a percentage.	12 weeks
Secondary	End of life quality indicators	End of life quality indicators will be extracted from the electronic medical record. These metrics will include hospice enrollment, palliative care referral, chemotherapy administration within the last 2 weeks of life, emergency department visits in the last 30 days of life, intensive care unit admissions in the last 30 days of life, hospitalizations in the last 30 days of life, use of life-sustaining treatments in the last 30 days of life, transfusions in the last 7 days of life, and place of death. These will be expressed as percentages.	Up to 5 years following their participation in the study or death