Emergency Medicine Palliative Care Access

Summary

This is a two-arm, multi-site randomized controlled trial of 1,350 older adults (50+ years) with either advanced cancer (defined as metastatic solid tumor) or poor prognosis end-stage organ failure (New York Heart Association (NYHA) Class III or IV Congestive Heart Failure (CHF), End-Stage Renal Disease (ESRD), defined as Glomerular Filtration Rate (GFR) \< 15 ml/min/m2 or dialysis ; or Global Initiative for Chronic Obstructive Lung Disease (GOLD) Stage III or higher, or oxygen-dependent chronic obstructive pulmonary disease (COPD) who present to the Emergency Department (ED), along with 675 of their informal caregivers. Investigators will compare the effectiveness of two distinct palliative care models: a) nurse-led telephonic case management; and b) facilitated, outpatient specialty palliative care.

Conditions

• Advanced Cancer
• End Stage Organ Failure

Interventions

BEHAVIORAL

Nurse-led telephonic case management

Telephonic meetings with a palliative care nurse. Palliative care is specialized medical care focused on providing a personalized layer of support dedicated to helping patients and their families cope with a serious illness.

BEHAVIORAL

Facilitated,outpatient specialty palliative care

In-person or telehealth palliative care visits with a palliative care provider. Palliative care is specialized medical care focused on providing a personalized layer of support dedicated to helping patients and their families cope with a serious illness.

Sponsors & Collaborators

• Beaumont Health

  collaborator OTHER

• Dana-Farber/Brigham and Women's Cancer Center

  collaborator OTHER

• Ohio State University

  collaborator OTHER

• University of Florida

  collaborator OTHER

• Yale University

  collaborator OTHER

• Patient-Centered Outcomes Research Institute

  collaborator OTHER

• Hackensack Meridian Health

  collaborator OTHER

• Atlantic Health System

  collaborator OTHER

• University of California, Irvine

  collaborator OTHER

• University of California, San Diego

  collaborator OTHER

• University of California, Los Angeles

  collaborator OTHER

• Northwestern University

  collaborator OTHER

• Rush University

  collaborator OTHER

• Henry Ford Health System

  collaborator OTHER

• NYU Langone Health

  lead OTHER

Principal Investigators

• Corita R. Grudzen, MD, MSHS, FACEP · Memorial Sloan Kettering Cancer Center

• Keith S. Goldfeld, DrPH, MS, MPA · NYU Langone Health

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-03-28

Primary Completion

2023-08-24

Completion

2023-08-24

Countries

• United States

Study Locations