Technology-enhanced Transitional Care for Rural Palliative Care Patients: A Pilot Study
TPC
1 other identifier
interventional
17
1 country
1
Brief Summary
The purpose of this pilot study is to develop and test a technology-enhanced transitional palliative care (TPC) intervention for patients and caregivers living in rural locations. The investigators hypothesize that access to palliative care will be improved, thereby improving patient and caregiver reported outcomes and decreasing the use of costly health services.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for not_applicable
Started Sep 2013
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
August 29, 2013
CompletedStudy Start
First participant enrolled
September 1, 2013
CompletedFirst Posted
Study publicly available on registry
September 4, 2013
CompletedPrimary Completion
Last participant's last visit for primary outcome
February 1, 2015
CompletedStudy Completion
Last participant's last visit for all outcomes
February 1, 2015
CompletedFebruary 16, 2015
February 1, 2015
1.4 years
August 29, 2013
February 13, 2015
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Change in mean scores on FACIT-Pal Questionnaire
The patient's quality of life will be determined by the change in mean scores from baseline to 1 month and 2 months post enrollment, using the Functional Assessment of Chronic Illness Therapy - Palliative Care Scale (FACIT-Pal). The FACIT-Pal palliative subscale contains 19 questions specific to persons with life-limiting illness. Each item is rated on a 5 point numeric rating scale from 9 (not at all) to 4 (very much). Scores range from 0-76. Higher scores indicate better quality of life.
Baseline, 1 month post-enrollment, 2 months post-enrollment
Secondary Outcomes (1)
Change in mean scores on ESAS-r Questionnaire
Baseline, 1 month post-enrollment, 2 months post-enrollment
Other Outcomes (1)
Health Care Service Utilization
Baseline to 6 months after enrollment
Study Arms (2)
Technology-Enhanced TPC
ACTIVE COMPARATORIn addition to receiving usual palliative care service in the hospital setting, Technology-Enhanced Transitional Palliative Care patients will receive Transitional Care from the Palliative Care consulting team beginning in the hospital within 24 hours of study enrollment and continuing post discharge for eight weeks in their homes in rural locations by means of video visits with the Palliative Care consulting team.
Usual standard of care
OTHERThe control group will receive only the current standard palliative care service in the hospital setting, which includes standard in-hospital palliative care consultation and standard discharge planning.
Interventions
The Transitional Care intervention will be initiated within 24 hours after enrollment, and will include initial transitional care planning, daily hospital visits, crisis prevention planning by an experienced Palliative Care nurse. The intervention will continue after the patient is discharged to home or short term skilled nursing facility, and it will involve an in-person visit between 24-48 hours post discharge, weekly virtual visits via iPad and video conference technology, and additional home visits as needed. Care plans established during initial planning will be implemented and adjusted under the guidance of the palliative care nurse delivering the intervention.
Usual care includes routine hospital discharge planning and usual physician care in primary and specialty outpatient clinics post hospital discharge. The PC consulting service provides consulting services in the inpatient setting. There are no standardized, intentional services provided to outpatients by the PC consulting team. Services provided to outpatients may occur sporadically as initiated by the patient. The majority of PC follow-up if any is a single phone call to the patient/caregiver. To account for the time spent and number of contacts made with the intervention group, the control group will be contacted by phone weekly by a non-nurse member of the study team not involved with the intervention, asked to relate what, if any, medically-related events occurred.
Eligibility Criteria
You may qualify if:
- Adult patients hospitalized at study site, and their designated caregiver (if available)
- Receiving palliative care
- Returning home or to a facility for short term (30 days) rehabilitation
- Able to provide informed consent
- Able to complete self-reported questionnaires without assistance
You may not qualify if:
- Long-term placement in skilled nursing facility after hospitalization
- Receiving hospice
- Living within city limits of hospital
- Cognitive impairments
- Non-English speaking
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Mayo Cliniclead
Study Sites (1)
Mayo Health System
Mankato, Minnesota, 56001, United States
Study Officials
- PRINCIPAL INVESTIGATOR
Diane E Holland, PhD, RN
Mayo Clinic
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Purpose
- SUPPORTIVE CARE
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Clinical Nurse Researcher
Study Record Dates
First Submitted
August 29, 2013
First Posted
September 4, 2013
Study Start
September 1, 2013
Primary Completion
February 1, 2015
Study Completion
February 1, 2015
Last Updated
February 16, 2015
Record last verified: 2015-02