Eliciting Informed Goals of Care in Elderly Patients

Summary

Patient-centered medical care considers a patient's values and goals for their health and well-being. Healthcare providers use this information to formulate a medical care plan that is aligned with these expectations. This shared-decision making process should occur with every medical decision, but it is especially important whenever decisions about end-of-life care are being considered. Eliciting patient preferences about resuscitation and life-support treatments in the event of life-threatening illnesses are considered to be a standard of excellent and appropriate medical care. Unfortunately, these discussions don't happen consistently and even when they do occur, are rarely ideal. The consequences can be devastating, often resulting in the delivery of unwanted medical care that can be associated with significant physical and mental suffering among patients and their families. In response to this problem, the investigators developed a novel tool to help guide these difficult conversations between healthcare providers and patients. The investigators previously tested this tool in a small group of hospitalized patients who found it acceptable and helpful. In this larger study, the investigators will compare how effective this tool is compared to usual care in ensuring hospitalized patients have their treatment preferences identified, documented and result in end-of-life care that is consistent with their preferences.

Conditions

• Goals of Care
• Patient Preference
• End of Life

Interventions

OTHER

GOCD Tool

Web-based tool with 4 components; pre-admission health status; current illness prognosis for hospital survival; in-hospital cardiorespiratory arrest prognosis; values and goals of care

OTHER

Usual care

Attending physicians responsible for GOCD during hospitalization using their usual approaches

Sponsors & Collaborators

• Royal Victoria Regional Health Centre

  collaborator UNKNOWN

• Royal Victoria Hospital, Canada

  lead OTHER

Principal Investigators

• Giulio DiDiodato, MD PhD · Royal Victoria Regional Health Centre

• Chris Martin, MD · Royal Victoria Regional Health Centre

• Doug Austgarden, MD · Royal Victoria Regional Health Centre

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

80 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-10-03

Primary Completion

2026-12-31

Completion

2027-06-01

Countries

• Canada

Study Locations