Computer Assisted Symptom Evaluation of Complex Patients

NCT ID: NCT01391026

Last Updated: 2023-06-22

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 200 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-06-30
• Study Completion Date: 2012-10-31

Brief Summary

Patients who have advanced or multiple chronic illnesses present management difficulties for primary care providers. Acute medical issues and limited time for patient evaluation can complicate complete assessment of physical symptoms that directly impact a patient's quality of life. The Cook County Health and Hospitals System (CCHHS) established an Advanced Illness Management Clinic to provide care for complex patients. Patient entry into the Advanced Illness Management Clinic is by referral only, a passive process. After discharge, general medicine clinic patients who do not have a medical provider are given an appointment in the clinic. Since the hospital is the source of many patients, this guarantees that these patients will have at least one illness advanced enough to require hospitalization, and most will have additional chronic illnesses. An outpatient palliative care clinic located in a specialty clinic setting was initiated in 2004. The goal of the clinic was to extend the benefits realized by hospital patients, for whom palliative care consultation has been available for many years, to patients cared for in the outpatient setting. The benefits provided include physical symptom management, spiritual counseling, and support for social issues. Until recently, this outpatient palliative care model has mainly served patients with malignancy. With the addition of the Advanced Illness Management Clinic, palliative care clinicians now can provide care to patients with other chronic and serious illness in the primary care setting.

Hypothesis: Complex patients will have improved quality of life and a reduced symptom burden if seen by a multidisciplinary clinic post-hospitalization, compared to usual care in a general medicine clinic.

Detailed Description

Outcome measures:

1. Quality of life as measured by the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS) short form

2. Physical symptom burden as measured by the Memorial Symptom Assessment Scale (MSAS), short form

Conditions

Multiple Co-morbidities

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Usual care

Patients will receive usual care by their primary care physicians without automated referral to specialized providers.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Enhanced patient-centered care

Patients will be evaluated and treated in the advanced illness management clinic

Group Type: EXPERIMENTAL

Enhanced patient-centered care

Intervention Type: BEHAVIORAL

The experimental arm will be referred to a multi-disciplinary clinic

Interventions

Enhanced patient-centered care

The experimental arm will be referred to a multi-disciplinary clinic

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• English or Spanish speaker
• Must be a general medicine clinic patient
• Must have a physical symptom score on MSAS above threshold (i.e., 1.0 or higher)
• Must have a phone number for contact

Exclusion Criteria

• Visual or cognitive impairment

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 110 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role: collaborator

Cook County Health

OTHER_GOV

Sponsor Role: lead

Responsible Party

William Trick

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

William E Trick, MD

Role: PRINCIPAL_INVESTIGATOR

Cook County Health & Hospitals System

Locations

Stroger Hospital of Cook County

Chicago, Illinois, United States

Countries

United States

Other Identifiers

1R24HS019481-01

Identifier Type: AHRQ

Identifier Source: secondary_id

View Link

10-143

Identifier Type: -

Identifier Source: org_study_id