Operationalizing needs-focused palliative care for older adults in intensive care units: Design of and rationale for the PCplanner randomized clinical trial.
Critical illness
Electronic health record (EHR) systems
Intensive care units
Mobile app
Palliative care
Randomized clinical trial (RCT)
Journal
Contemporary clinical trials
ISSN: 1559-2030
Titre abrégé: Contemp Clin Trials
Pays: United States
ID NLM: 101242342
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
24
07
2020
revised:
25
09
2020
accepted:
27
09
2020
pubmed:
3
10
2020
medline:
25
9
2021
entrez:
2
10
2020
Statut:
ppublish
Résumé
The number of older adults who receive life support in an intensive care unit (ICU), now 2 million per year, is increasing while survival remains unchanged. Because the quality of ICU-based palliative care is highly variable, we developed a mobile app intervention that integrates into the electronic health records (EHR) system called PCplanner (Palliative Care planner) with the goal of improving collaborative primary and specialist palliative care delivery in ICU settings. To describe the methods of a randomized clinical trial (RCT) being conducted to compare PCplanner vs. usual care. The goal of this two-arm, parallel group mixed methods RCT is to determine the clinical impact of the PCplanner intervention on outcomes of interest to patients, family members, clinicians, and policymakers over a 3-month follow up period. The primary outcome is change in unmet palliative care needs measured by the NEST instrument between baseline and 1 week post-randomization. Secondary outcomes include goal concordance of care, patient-centeredness of care, and quality of communication at 1 week post-randomization; length of stay; as well as symptoms of depression, anxiety, and post-traumatic stress disorder at 3 months post-randomization. We will use general linear models for repeated measures to compare outcomes across the main effects and interactions of the factors. We hypothesize that compared to usual care, PCplanner will have a greater impact on the quality of ICU-based palliative care delivery across domains of core palliative care needs, psychological distress, patient-centeredness, and healthcare resource utilization.
Identifiants
pubmed: 33007442
pii: S1551-7144(20)30241-X
doi: 10.1016/j.cct.2020.106163
pmc: PMC7686302
mid: NIHMS1637252
pii:
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
106163Subventions
Organisme : NIA NIH HHS
ID : R01 AG058915
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
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