Timing of Acute Palliative Care Consultation in Critically Ill Patients

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Brief Summary

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A prospective randomized controlled trial studying the ordering of palliative care consultations in the emergency department (Ig) versus later palliative care consultations in the hospital--ICU or hospital ward(Cg). Patients will be randomly allocated to Ig or Cg with a 1:1 ratio.

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Detailed Description

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Conditions

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Multiple Organ Failure End Stage Cardiac Failure End Stage Chronic Obstructive Airways Disease Chronic Kidney Disease Stage 5 Hepatic Encephalopathy Sepsis Dementia Multiple Sclerosis Parkinson's Disease In-Hospital Cardiac Arrest Solid Organ Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Interventional group (Ig)

The interventional group (Ig) will have an early palliative care consultation ordered during their stay in the emergency department.

Group Type EXPERIMENTAL

Early order of palliative care consultation

Intervention Type OTHER

Control group (Cg)

The control group will be treated as standard of care. Palliative care consultations may or may not be ordered at the attending physician's discretion.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Early order of palliative care consultation

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Greater than or equal to 65 years old
* Treated in a resuscitation room for unstable vital signs or respiratory compromise
* One or more of the following:
* Advanced or metastatic solid organ cancer
* End stage organ failure of the heart, lung/COPD, kidney on dialysis, hepatic encephalopathy
* Suspected sepsis
* Advanced dementia, end-state multiple sclerosis or Parkinson's disease
* Status post cardiac arrest with coma (Glascow coma score \<7)
* Patient is from a skilled nursing facility

Exclusion Criteria

* Lack decision capacity and have no relative available during ED stay to consent to the study (legally authorized representative-LAR)
* Enrolled in hospice care prior to randomization
* A copy of a completed advance directive which names a designated proxy provided physically to the medical team prior to randomization
* Wearing a DNR bracelet
* Have been previously enrolled in this study

Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No