Palliative Care Clinical Trial
Official title:
Testing a Video Decision Support Tool to Supplement Goals-of-Care Discussions With Patients and Surrogates Receiving an Inpatient Palliative Care Consult
Subject preferences for care at the end-of-life show wide variability. In the setting of
advanced disease, some subjects prefer all life-sustaining care while others forgo such
procedures. The wide variability in preferences may be due to subjects' misconception of the
disease condition when using solely verbal descriptions. The failure to participate in
effective goals-of-care discussions may lead to overuse of medical interventions and
life-sustaining measures that are inconsistent with patients' and families' wishes. Using
video images -- in addition to words -- to convey goals-of-care options at end-of-life, adds
a sense of verisimilitude to the condition described and may better inform subjects when
making their preferences.
Specific Aim: To assess the effect of a video decision support tool on preferences for
end-of-life care in patients and surrogate decision makers consulted on by an inpatient
palliative care service. The investigators hypothesize that those subjects who view video
images as a supplement to a standard palliative care consult will be more likely to opt for
comfort oriented care.
In this study, patient subjects and/or their healthcare proxies who are consulted on by an
inpatient palliative care team will be surveyed regarding their preferences for end-of-life
care following either a standard palliative care consult or one which utilizes a short video
to complement verbal descriptions. The primary analysis will involve the proportion of
patient subjects/proxies in each group that prefer comfort oriented care and that die in
accordance with their stated preferences. The investigators will also study the effect of
the video on patient subjects' and/or proxies' uncertainty with regard to treatment
preferences and overall satisfaction with the palliative care consult.
The investigators research will be conducted as a non-randomized, temporal intervention study. The specific aim of the study is to assess the effect of a video decision support tool on preferences for end-of-life care in patients and surrogate decision makers consulted on by an inpatient palliative care service. The first seven months of the study, or until 25 patient subjects are recruited, will be the observational phase. All participants recruited will receive the usual standard of care provided by an inpatient palliative care service. Using a battery of surveys, data will be collected regarding treatment preferences near the end of life, level of certainty with decision making, pain and symptom management, resource utilization and whether patient subjects die in accordance with their stated preferences. Once the observational phase is complete, the intervention phase of the study will begin. Over the following seven months, or until 25 patient subjects are recruited, all participants will view a six-minute digital video outlining different options for care near the end of life. The same endpoints will then be followed. In addition to the primary analysis involving patient-proxy dyads, an additional exploratory analysis will be performed. This analysis will involve surveying additional medical staff including attendings, residents, interns and nurses regarding their perceptions of patients' symptoms at the time of the palliative care consult. This data will be used to measure concordance between patient subjects' and staffs' ranking of symptoms. ;
Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT04673760 -
The PROAKTIV Study
|
N/A | |
Completed |
NCT03520023 -
Critical Care and Palliative Care Medicine Together in the ICU
|
N/A | |
Completed |
NCT01990742 -
Improving Palliative Care Through Teamwork
|
N/A | |
Not yet recruiting |
NCT05434208 -
Effects of Nurse-led Telephone Based Service for Early Palliative Care (PALTEL)
|
N/A | |
Not yet recruiting |
NCT03267706 -
Introducing the Palliative Care Comprehensive Tool in Family Medicine
|
N/A | |
Completed |
NCT02845817 -
Requests for Euthanasia and Assisted Suicide
|
N/A | |
Recruiting |
NCT02778347 -
Development and Validation of a Comprehensive Standardised Clinical Assessment Tool for Patient Needs
|
N/A | |
Completed |
NCT01933789 -
Improving Communication About Serious Illness
|
N/A | |
Completed |
NCT01934413 -
Technology-enhanced Transitional Care for Rural Palliative Care Patients: A Pilot Study
|
N/A | |
Recruiting |
NCT01170000 -
Timely End-of-Life Communication to Parents of Children With Brain Tumors
|
N/A | |
Recruiting |
NCT04052074 -
Complementary Therapy in Home Palliative Care Patients and Their Caregivers
|
N/A | |
Recruiting |
NCT05935540 -
ACP-Family Programme for Palliative Care Patients and Their Family Member
|
N/A | |
Active, not recruiting |
NCT02689375 -
A Prospective, Open Label, Pilot Study of Patient OutcoMes Following Successful TriAl of High Frequency SpInal CorD Stimulation at 10kHz (HF10™) Leading to Permanent Implant Compared to Trial Failure and Standard CarE for the TreatmeNt of Persistent Low BACK Pain of Neuropathic Origin
|
N/A | |
Recruiting |
NCT05520281 -
Short-term Psychodynamic Psychotherapy in Serious Physical Illness
|
N/A | |
Completed |
NCT06140004 -
Home-Based Palliative Care Impact on Providers
|
||
Completed |
NCT04333719 -
Prevalence of Deep Sedation in Terminal Palliative Phase
|
||
Recruiting |
NCT03286127 -
Palliative Outcome Evaluation Muenster I
|
||
Completed |
NCT06211816 -
Efficacy of End-of-life Communication Strategies on Nurses in the Intensive Care Unit
|
N/A | |
Completed |
NCT04857060 -
Palliative Care Educator
|
N/A | |
Completed |
NCT04491110 -
Intervention to Improve Quality of Sleep of Palliative Patient Carers in the Community: Clinical Trial
|
N/A |