The effectiveness of the Liverpool care pathway in improving end of life care for dying cancer patients in hospital. A cluster randomised trial.
The effectiveness of the Liverpool care pathway in improving end of life care for dying cancer patients in hospital. A cluster randomised trial.
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DOI：
10.1186/1472-6963-11-13
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发表时间：
2011-01-24
影响因子：
2.8
通讯作者：
LCP Randomised Italian Cluster Trial Study Group
中科院分区：
文献类型：
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作者：
Costantini M;Ottonelli S;Canavacci L;Pellegrini F;Beccaro M;LCP Randomised Italian Cluster Trial Study Group
大多数癌症患者仍然死在医院，主要是内科病房。不同国家的许多研究表明，医院提供的临终关怀质量很差。“利物浦临终病人护理路径”计划(LCP)是英国开发的，旨在将临终关怀模式转移到医院和其他护理环境中，是一项复杂的干预措施，旨在提高临终关怀的质量。定性和定量研究的结果表明，LCP计划可以显著提高医院临终关怀的质量，但到目前为止还没有进行随机试验。这是一项随机整群试验，按地区分层，并按评估期匹配。来自不同医院的符合条件的内科病房对将随机接受LCP-I计划或在试验结束前不进行干预。LCP-I方案将由姑息治疗单位实施。将对实验病房和对照病房在LCP-I实施结束后六个月内发生的所有癌症死亡进行终点评估。主要终点是在病房为临终癌症患者及其家人提供的临终关怀的整体质量，使用意大利语版本的工具包“死后丧亲家属访谈”的全球量表进行评估。根据医学研究理事会框架，这项研究可以被解释为第三阶段试验。在这项研究中，通过比较实验组和对照组中终点的分布来评估完全定义的干预的有效性。RFPS-2006-6-341619 ClinicalTrials.gov标识：NCT01081899
Most cancer patients still die in hospital, mainly in medical wards. Many studies in different countries have shown the poor quality of end-of-life care delivery in hospitals. The Program "Liverpool Care Pathway for the dying patient" (LCP), developed in the UK to transfer the hospice model of care into hospitals and other care settings, is a complex intervention to improve the quality of end-of-life care. The results from qualitative and quantitative studies suggest that the LCP Program can improve significantly the quality of end-of-life care delivery in hospitals, but no randomised trial has been conducted till now. This is a randomized cluster trial, stratified by regions and matched for assessment period. Pairs of eligible medical wards from different hospitals will be randomized to receive the LCP-I Program or no intervention until the end of the trial. The LCP-I Program will be implemented by a Palliative Care Unit. The assessment of the end-points will be performed for all cancer deaths occurred in the six months after the end of the LCP-I implementation in the experimental wards and, in the same period of time, in the matched control wards. The primary end-point is the overall quality of end-of-life care provided on the ward to dying cancer patients and their families, assessed using the Global Scale of the Italian version of the Toolkit "After-death Bereaved Family Member Interview". This study can be interpreted as a Phase III trial according to the Medical Research Council Framework. In this study, the effectiveness of a fully defined intervention is assessed by comparing the distribution of the endpoints in the experimental and in the control arm. RFPS-2006-6-341619 ClinicalTrials.gov Identifier: NCT01081899
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通讯作者：
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