LifeCourse: A Supportive Care Approach for Patients Late in Life

NCT01746446 | Completed

• 1 other identifier: 38632
• Study Type: interventional
• Target: 903
• Locations: 1 country
• Sites: 3

Brief Summary

The purpose of the study is to test a new model of care for patients with an ongoing or significant medical condition.

Conditions

Ongoing or Significant Medical Condition

Outcome Measures

Primary Outcomes (4)

• Patient Quality of Life

  Patient QOL was measured using the Functional Assessment of Chronic Illness Therapy-Palliative v4 (FACIT-Pal) survey, a general measure of health-related QOL in 4 domains: physical, social, emotional, and functional, plus a measure of end-of-life experiences. Items were reverse scored according to scoring guidelines and domain scores were calculated via prorated scores when there were \<50% missing items for a given domain and \<20% missing domains for a total score.

  Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years.

• Patient Care Experience

  Patient care experience was collected via a previously validated survey tool focused on the patient's experience with their care team in the last 30 days. Three domains were scored: care team, goals, and communication with prorated scores when there were \<50% missing items for a given domain and \<20% missing domains for a total score.

  Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years.

• Caregiver care experience

  Caregiver care experience was measured by a developed tool, addressing various aspects of care experience. An overall score was calculated by summing answers to all items. Scores were also calculated in 3 domains: care team, communication, and support.

  Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years.

• Caregiver Quality of Life

  aregiver QOL was assessed via the patient-reported outcomes measurement information system (PROMIS) which asks caregivers to report their QOL in 8 domains. The PROMIS-29 scores were calculated by summing answers to all items within each domain.

  Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years.

Study Arms (2)

Care team

EXPERIMENTAL

Patients are offered the support and services of the care team.

Other: Care team

Usual Care

NO INTERVENTION

Patients receive usual care.

Interventions

Care team OTHER

Provides additional support to patients, family, and friends.

Care team

Eligibility Criteria

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

You may qualify if:

• Patient has an Allina Health primary or specialty provider
• Patient's medical chart indicates an on-going or significant medical condition
• LifeCourse will invite vulnerable patients to enroll, including:
• Critically ill patients
• Cognitively impaired patients
• Elderly patients, some of whom may have cognitive impairment and/or be institutionalized

You may not qualify if:

• Patient resides in a zip code which does not lie partially within a 45 mile radius from the Allina Health Commons in Minneapolis, Minnesota.
• Patient has not visited an Allina facility, affiliate, or community partner within the last year.
• Patient is eligible for hospice.
• Patient is actively dying.
• Patient is abusive or is discharged against medical advice (AMA).

Sponsors & Collaborators

• Allina Health System: lead
• Robina Foundation: collaborator

Study Sites (3)

Augustana Health Care Center

Minneapolis, Minnesota, 55404, United States

Location

Abbott Northwestern Hospital

Minneapolis, Minnesota, 55407, United States

Location

Walker Methodist Health Center

Minneapolis, Minnesota, 55409, United States

Location

Related Publications (9)

• Schellinger S, Cain CL, Shibrowski K, Elumba D, Rosenberg E. Building New Teams for Late Life Care: Lessons From LifeCourse. Am J Hosp Palliat Care. 2016 Jul;33(6):561-7. doi: 10.1177/1049909115574692. Epub 2015 Mar 5.

  PMID: 25747670 BACKGROUND

• Fernstrom KM, Shippee ND, Jones AL, Britt HR. Development and validation of a new patient experience tool in patients with serious illness. BMC Palliat Care. 2016 Dec 30;15(1):99. doi: 10.1186/s12904-016-0172-x.

  PMID: 28038669 BACKGROUND

• Anderson EW, Frazer MS, Schellinger SE. Expanding the Palliative Care Domains to Meet the Needs of a Community-Based Supportive Care Model. Am J Hosp Palliat Care. 2018 Feb;35(2):258-265. doi: 10.1177/1049909117705061. Epub 2017 Apr 20.

  PMID: 28423918 BACKGROUND

• Anderson EW, White KM. "It Has Changed My Life": An Exploration of Caregiver Experiences in Serious Illness. Am J Hosp Palliat Care. 2018 Feb;35(2):266-274. doi: 10.1177/1049909117701895. Epub 2017 Apr 16.

  PMID: 28413927 BACKGROUND

• Schellinger SE, Anderson EW, Frazer MS, Cain CL. Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious Illness. Am J Hosp Palliat Care. 2018 Jan;35(1):159-165. doi: 10.1177/1049909117699600. Epub 2017 Mar 23.

  PMID: 28330379 BACKGROUND

• Shippee ND, Shippee TP, Mobley PD, Fernstrom KM, Britt HR. Effect of a Whole-Person Model of Care on Patient Experience in Patients With Complex Chronic Illness in Late Life. Am J Hosp Palliat Care. 2018 Jan;35(1):104-109. doi: 10.1177/1049909117690710. Epub 2017 Jan 29.

  PMID: 28133973 BACKGROUND

• Cain CL, Taborda-Whitt C, Frazer M, Schellinger S, White KM, Kaasovic J, Nelson B, Chant A. A mixed methods study of emotional exhaustion: Energizing and depleting work within an innovative healthcare team. J Interprof Care. 2017 Nov;31(6):714-724. doi: 10.1080/13561820.2017.1356809. Epub 2017 Sep 18.

  PMID: 28922038 BACKGROUND

• Anderson EW, White KM. "This Is What Family Does": The Family Experience of Caring for Serious Illness. Am J Hosp Palliat Care. 2018 Feb;35(2):348-354. doi: 10.1177/1049909117709251. Epub 2017 Jun 30.

  PMID: 28662594 BACKGROUND

• Britt HR, JaKa MM, Fernstrom KM, Bingham PE, Betzner AE, Taghon JR, Shippee ND, Shippee TP, Schellinger SE, Anderson EW. Quasi-Experimental Evaluation of LifeCourse on Utilization and Patient and Caregiver Quality of Life and Experience. Am J Hosp Palliat Care. 2019 May;36(5):408-416. doi: 10.1177/1049909118817740. Epub 2018 Dec 13.

  PMID: 30541333 DERIVED

Study Officials

• Eric W Anderson, MD

  Allina Health

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 27, 2012
• First Posted: December 11, 2012
• Study Start: October 1, 2012
• Primary Completion: March 31, 2017
• Study Completion: March 31, 2017
• Last Updated: June 8, 2022

Record last verified: 2022-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (3)