Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness
Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness
复制标题
DOI：
10.1136/bmjopen-2018-025692
复制
发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Young-Brinn, Angela
中科院分区：
文献类型：
--
作者：
Grudzen, Corita R.;Shim, Deborah J.;Young-Brinn, Angela
急诊科（ED）发起的姑息治疗已被证明可以改善患有严重生命限制疾病的老年人以患者为中心的结果。然而，提供此类干预措施的最佳方式尚不清楚。本研究旨在比较护士主导的电话病例管理与专科门诊姑息治疗对患有严重生命限制疾病的老年人的影响：(1)患者的生活质量；(2)医疗保健利用；(3)孤独感与症状负担；(4)照顾者压力、照顾者生活质量与丧亲关系。方法和分析这是一项实用的、多中心的、平行的、两组随机对照试验，在急症患者中比较两种既定的姑息治疗模式：护士主导的电话病例管理和专科门诊姑息治疗。我们将在9个急诊室招募1350名50岁以上的患者和675名他们的护理人员。符合条件的患者：(1)患有晚期癌症（转移性实体瘤）或终末期器官衰竭（纽约心脏协会III级或IV级心力衰竭，终末期肾小球滤过率肾病）
Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate