A Shared Care Approach for Seriously Ill Cancer Patients Between General Practice, Discharge Department and a Specialist Palliative Care Team

NCT00594971 | Withdrawn DMC

• 2 other identifiers: 15273887ISRCTN15273887
• Study Type: interventional
• Target: 270
• Locations: 0 countries
• Sites: N/A

Brief Summary

Background: Approximately one third of all deaths in Denmark are caused by cancer. Both Danish and international research shows that the majority of terminally ill cancer patients wish to die at home. In Denmark only about 25% has this wish fulfilled. The General Practitioner (GP) has traditionally had the full responsibility for the palliative care of terminally ill cancer patients. In recent years changes have been made to the organisation of palliative care: some hospitals have set up specialised palliative care teams and in some areas of Denmark hospices have been established. Recent research defines a problem when it comes to communication between the hospital and general practice when the patient is being discharged. This is often done in a way that can cause the patient to feel "left in limbo", especially if it is not completely clear to the patient and his or her relatives who has the responsibility for the palliative care. Objective:

1. 1.To describe consequences for patients, relatives and health care professionals of three different ways of organising palliative care
2. 2.To collect data which describes patients who are candidates to a shared care approach between general practice and a specialised palliative care team
3. 3.To collect data which describes the palliative phase (place of death and palliative care, admissions to hospital, involvement of GP and district nurse etc.)
4. 4.To describe terminally ill cancer patients and their relatives expectations of the health care system

Conditions

Palliative Care; Neoplasms

Keywords

Health Services Research; Family practice

Outcome Measures

Primary Outcomes (3)

• Patients wish for place of death and place of terminal care fulfilled

  The patient will be asked about preference for place of death and place for terminal care at inclusion and a month later. At the time of death we will be able to establish weather the patient had his or her wishes fulfilled.

• Relative amount of time spent in hospital in the terminal phase

  At the patients time of death we will be able to count number of days spent in hospital using the hospitals electronic patient files.

• A subjective measure of the patients symptoms and quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire of Palliative care [EORTC-QLQ-15-PAL])

  Will be measured at the time of inclusion and a month later.

Secondary Outcomes (9)

• Patient's satisfaction regarding the services of the GP, district nurse and local hospital

  Will be measured at inclusion and one month later.

• Patient's experiences regarding cooperation and information sharing in the health care system.

  Will be measured at inclusion and one month later.

• Relative's satisfaction regarding the services of the GP, district nurse and local hospital.

  Will be measured at inclusion, one month later and 2 months after the patients death.

• Relative's experiences regarding cooperation and information sharing in the health care system.

  Will be measured at inclusion, one month later and 2 months after the patients death.

• Relative's experiences regarding the palliative treatment of the patient.

  Will be measured at inclusion, one month later and 2 months after the patients death.

Study Arms (3)

B

OTHER

90 terminally ill cancer patients will be referred to a specialist palliative care team at time of discharge.

Other: Referral to a specialist palliative care team.

C

OTHER

90 terminally ill cancer patients will be discharged from hospital with extra effort put into improving the communication between the hospital and the primary sector.

Other: Organisational intervention

A

NO INTERVENTION

90 terminally ill cancer patients will be discharged from hospital, receiving usual care.

Interventions

Organisational intervention OTHER

A shared care approach in which extra effort is put into improving the communication between the hospital and the primary sector.

C

Referral to a specialist palliative care team. OTHER

Discharge with referral to a specialist palliative care team. This is a patient-centred shared care model in which the palliative team helps to organise the patient's treatment and care.

B

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• In order to be included the patients have to be diagnosed as suffering from terminal cancer. The patients should also:
• Be 18 years or older
• Be able to speak and write Danish fluently
• Give written and spoken consent
• Be able to manage in their own home, with or without the help of carers and district nurses
• Be informed about the diagnosis, also that it is incurable
• Be registered as suffering from a terminal illness or fulfil the criteria for this -

You may not qualify if:

• Patients are excluded if they:
• Have a low level of cognitive skills, which makes it difficult for them to fill in a questionnaire
• Are receiving oncologic treatment which requires attending an out-patients clinic regularly

Sponsors & Collaborators

• University of Aarhus: lead
• Research Unit for General Practice, Aarhus University: collaborator
• Aarhus University Hospital: collaborator

MeSH Terms

Conditions

Neoplasms

Study Officials

• Frede Olesen, Professor

  Research Unit for General Practice, Aarhus University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: January 7, 2008
• First Posted: January 16, 2008
• Study Start: April 1, 2008
• Primary Completion: October 1, 2009
• Study Completion: November 1, 2010
• Last Updated: January 11, 2011

Record last verified: 2011-01