A Pragmatic Trial of an Active Choice Nudge for Generalist or Specialist Palliative Care for Seriously Ill Inpatients
NCT ID: NCT05502861
Last Updated: 2025-11-20
Study Results
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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ACTIVE_NOT_RECRUITING
NA
16000 participants
INTERVENTIONAL
2023-11-13
2026-06-30
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
CROSSOVER
HEALTH_SERVICES_RESEARCH
TRIPLE
Study Groups
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Intervention
The study's intervention is a prognostic-triggered EHR alert to nudge clinicians to provide generalist or specialist PC. The alert notifies the clinician that the patient is likely to benefit from PC, and requires clinicians to actively choose to provide generalist PC themselves, consult PC specialist, or to defer PC. If a clinician chooses to consult specialist PC, a second alert will fire that enables them to easily and quickly place the consult order. The alert will trigger for all patients with moderate or higher 6-month mortality risk on second full hospital day at 8AM.
Generalist + Specialist palliative care
Clinicians are alerted in the EHR to make an active choice whether to provide generalist palliative care themselves, consult PC specialist, or to defer PC at that time.
Control/Usual Care
During the control phase, patients meeting eligibility criteria will be enrolled for study data collection but there will be no attempt to influence delivery of care. The length of the control phase will differ at each hospital dependent on the sequence in which hospitals are randomly assigned to switch to the intervention phase. All hospitals contribute a minimum of 15 weeks of outcomes data prior to adopting the intervention.
Pre-Intervention phase
Patients meeting eligibility criteria will be enrolled for study data collection but there will be no attempt to influence delivery of care.
Interventions
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Generalist + Specialist palliative care
Clinicians are alerted in the EHR to make an active choice whether to provide generalist palliative care themselves, consult PC specialist, or to defer PC at that time.
Pre-Intervention phase
Patients meeting eligibility criteria will be enrolled for study data collection but there will be no attempt to influence delivery of care.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Inpatient or observation admission status at a study hospital
* Predicted 6-month mortality risk moderate (e.g., ≥40%) or higher
Exclusion Criteria
* Inpatient primary service: hospice, rehabilitation, obstetrics, psychiatry
* Patients that have died or been discharged before 0800 on hospital day 3 when the mortality risk is generated and enrollment occurs
18 Years
ALL
No
Sponsors
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National Institute on Aging (NIA)
NIH
University of Pennsylvania
OTHER
Responsible Party
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Katherine Courtright
Assistant Professor of Medicine
Principal Investigators
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Katherine R Courtright, MD, MS
Role: PRINCIPAL_INVESTIGATOR
University of Pennsylvania
Locations
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University of Pennsylvania
Philadelphia, Pennsylvania, United States
Countries
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Other Identifiers
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848497
Identifier Type: -
Identifier Source: org_study_id
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