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

NCT ID: NCT05640076

Last Updated: 2023-07-13

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

COMPLETED

Total Enrollment

2831 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-04-01

Study Completion Date

2023-06-01

Brief Summary

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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.

Detailed Description

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Conditions

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Palliative Medicine Hospice and Palliative Care Nursing Palliative Care

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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2018-19 - Oncologic patients under home palliative care

Oncologic patients took over from the Metropolitan Palliative Care Service and receiving home palliative care within their last 90 days of life between 1/1/2018 and 31/12/2019

24/7 Telephonic Palliative Care Service availability

Intervention Type OTHER

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.

2018-19 - Non-oncologic patients under home palliative care

Non-oncologic patients took over from the Metropolitan Palliative Care Service and receiving home palliative care within their last 90 days of life between 1/1/2018 and 31/12/2019

No interventions assigned to this group

2021-2022 - Oncologic patients under home palliative care

Oncologic patients took over from the Metropolitan Palliative Care Service and receiving home palliative care within their last 90 days of life between 1/1/2021 and 31/12/2022

24/7 Telephonic Palliative Care Service availability

Intervention Type OTHER

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.

2021-2022 - Non-Oncologic patients under home palliative care

Non-oncologic patients took over from the Metropolitan Palliative Care Service and receiving home palliative care within their last 90 days of life between 1/1/2021 and 31/12/2022

24/7 Telephonic Palliative Care Service availability

Intervention Type OTHER

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.

Interventions

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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.

Intervention Type OTHER

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS Azienda Ospedaliero-Universitaria di Bologna

OTHER

Sponsor Role collaborator

Azienda Usl di Bologna

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Azienda Unità Sanitaria Locale

Bologna, , Italy

Site Status

IRCCS - Policlinico Universitario S.Orsola - Malpighi

Bologna, , Italy

Site Status

Countries

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Italy

References

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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.

Reference Type BACKGROUND
PMID: 12886178 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 16689410 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33499835 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 16595540 (View on PubMed)

Valenti D, Gamberini L, Allegri D, Tartaglione M, Moggia F, Del Giudice D, Baroni R, Di Mirto CVF, Tamanti J, Rosa S, Paoletti S, Bruno L, Peterle C, Cuomo AMR, Bertini A, Giostra F, Mengoli F; Collaborators. Effects of 24/7 palliative care consultation availability on the use of emergency department and emergency medical services resources from non-oncological patients: a before-and-after observational cohort study. BMJ Support Palliat Care. 2024 Dec 19;14(e3):e2788-e2797. doi: 10.1136/spcare-2023-004412.

Reference Type DERIVED
PMID: 37973206 (View on PubMed)

Other Identifiers

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FEDERATION

Identifier Type: -

Identifier Source: org_study_id

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