Effects of a 24/7 Palliative Care Service Integration in a Metropolitan Area on Non-oncologic Patients

Palliative Care Clinical Trial

Official title:

Effects of a 24/7 Palliative Care Service Integration in a Metropolitan Area on Non-oncologic Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05640076
• Other study ID #: FEDERATION
• Status: Completed
• Start date: April 1, 2023
• Est. completion date: June 1, 2023

Study information

• Verified date: June 2023
• Source: Azienda Usl di Bologna
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This retrospective observational pre-post study aims to test the effects of introducing a remote telephonic consultation availability from the Palliative Care Service for a cohort of non-oncologic patients followed by the same service, their relatives, and the Emergency Medical Services (EMS) and family care physicians taking care of them.

The main question[s] it aims to answer are:

• Does the introduction of a remote telephonic consultation availability affect the rate of ED access of non-oncologic Palliative-care followed patients during their last 90 days of life?

• Does the introduction of a remote telephonic consultation availability have an effect on the rate of EMS requests for these patients during their last 90 days of life?

• Which are the main topics of the calls to the Palliative Care Service?

Due to the emergence of COVID-19 pandemic during the study period, a parallel cohort of oncologic patients under 24/7 palliative care by the same service during both the observation periods will be used as reference.

Participants will be followed up from the date of taking-over request to the Palliative Care Service to their death or the end of the period of observation if followup began during their last 90 days of life.

Otherwise, for those being already under home palliative care at the 90th day before their death, follow up will begin at that day.

Researchers will compare two time periods to see if the introduction of a remote telephonic consultation availability has an effect on the supra-mentioned aims.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 2831
• Est. completion date: June 1, 2023
• Est. primary completion date: June 1, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients followed by the Metropolitan Palliative Care Service of Bologna

• Residency in Bologna Metropolitan city

Exclusion Criteria:

• Incomplete data

• Residency outside Bologna Metropolitan City

Related Conditions & MeSH terms

• Palliative Care
• Palliative Medicine

Intervention

Other:
• 24/7 Telephonic Palliative Care Service availability
Metropolitan Palliative Care Service-implemented 24/7 telephonic availability service for the patients, their relatives, the EMS and Primary Care physicians taking care of them. After consultation, if the information and medical suggestions are not sufficient, an urgent ambulatory or home visit could be planned.

Locations

Country	Name	City	State
Italy	Azienda Unità Sanitaria Locale	Bologna
Italy	IRCCS - Policlinico Universitario S.Orsola - Malpighi	Bologna

Sponsors (2)

Lead Sponsor	Collaborator
Azienda Usl di Bologna	IRCCS Azienda Ospedaliero-Universitaria di Bologna

Country where clinical trial is conducted

Italy, 

References & Publications (4)

Barbera L, Paszat L, Chartier C. Indicators of poor quality end-of-life cancer care in Ontario. J Palliat Care. 2006 Spring;22(1):12-7. — View Citation

Burge F, Lawson B, Johnston G. Family physician continuity of care and emergency department use in end-of-life cancer care. Med Care. 2003 Aug;41(8):992-1001. doi: 10.1097/00005650-200308000-00012. — View Citation

Gamblin V, Prod'homme C, Lecoeuvre A, Bimbai A-, Luu J, Hazard PA, Da Silva A, Villet S, Le Deley MC, Penel N. Home hospitalization for palliative cancer care: factors associated with unplanned hospital admissions and death in hospital. BMC Palliat Care. 2021 Jan 26;20(1):24. doi: 10.1186/s12904-021-00720-7. — View Citation

Thomsen JL, Parner ET. Methods for analysing recurrent events in health care data. Examples from admissions in Ebeltoft Health Promotion Project. Fam Pract. 2006 Aug;23(4):407-13. doi: 10.1093/fampra/cml012. Epub 2006 Apr 4. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Emergency Department Admission rate of patients followed by the Palliative Care Service		48 months
Secondary	EMS calls rate from patients followed by the Palliative Care Service		48 months
Secondary	Main topics of the calls received from the Palliative Care Service after the full implementation of a 24/7 service	Classification of the topics of the calls into 5 main classes: "Clinical questions", "Caregiver Support", "Definition of care pathway", "Palliative sedation", "Other communications".; The relative frequency of each main topic will be reported	24 months