Computer Assisted Symptom Evaluation of Complex Patients

NCT01391026 | Completed

• 2 other identifiers: 10-1431R24HS019481-01
• Study Type: interventional
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

Patients who have advanced or multiple chronic illnesses present management difficulties for primary care providers. Acute medical issues and limited time for patient evaluation can complicate complete assessment of physical symptoms that directly impact a patient's quality of life. The Cook County Health and Hospitals System (CCHHS) established an Advanced Illness Management Clinic to provide care for complex patients. Patient entry into the Advanced Illness Management Clinic is by referral only, a passive process. After discharge, general medicine clinic patients who do not have a medical provider are given an appointment in the clinic. Since the hospital is the source of many patients, this guarantees that these patients will have at least one illness advanced enough to require hospitalization, and most will have additional chronic illnesses. An outpatient palliative care clinic located in a specialty clinic setting was initiated in 2004. The goal of the clinic was to extend the benefits realized by hospital patients, for whom palliative care consultation has been available for many years, to patients cared for in the outpatient setting. The benefits provided include physical symptom management, spiritual counseling, and support for social issues. Until recently, this outpatient palliative care model has mainly served patients with malignancy. With the addition of the Advanced Illness Management Clinic, palliative care clinicians now can provide care to patients with other chronic and serious illness in the primary care setting. Hypothesis: Complex patients will have improved quality of life and a reduced symptom burden if seen by a multidisciplinary clinic post-hospitalization, compared to usual care in a general medicine clinic.

Conditions

Multiple Co-morbidities

Keywords

Medical informatics; Health services accessibility

Outcome Measures

Primary Outcomes (1)

• NIH PROMIS 10-item short form quality of life

  We will assess the physical and mental components of the quality of life instrument

  6 months

Secondary Outcomes (2)

• MSAS physical symptom score

  6 months

• Healthcare utilization

  6 months

Study Arms (2)

Usual care

NO INTERVENTION

Patients will receive usual care by their primary care physicians without automated referral to specialized providers.

Enhanced patient-centered care

EXPERIMENTAL

Patients will be evaluated and treated in the advanced illness management clinic

Behavioral: Enhanced patient-centered care

Interventions

Enhanced patient-centered care BEHAVIORAL

The experimental arm will be referred to a multi-disciplinary clinic

Enhanced patient-centered care

Eligibility Criteria

• Age: 18 Years - 110 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• English or Spanish speaker
• Must be a general medicine clinic patient
• Must have a physical symptom score on MSAS above threshold (i.e., 1.0 or higher)
• Must have a phone number for contact

You may not qualify if:

• Visual or cognitive impairment

Sponsors & Collaborators

• Cook County Health: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

Stroger Hospital of Cook County

Chicago, Illinois, 60612, United States

Location

Study Officials

• William E Trick, MD

  Cook County Health & Hospitals System

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 7, 2011
• First Posted: July 11, 2011
• Study Start: June 1, 2011
• Primary Completion: October 1, 2012
• Study Completion: October 1, 2012
• Last Updated: June 22, 2023

Record last verified: 2023-06

Locations

US (1)