NCT04118569

Brief Summary

Disparities in palliative care for patients with serious illness exist because of gaps in knowledge around patient centered psychological, social, and spiritual palliative care interventions. Patient-centered palliative care communication interventions must be informed by the perspectives of patients who are living each day with their serious illness. Yet, there is a lack of research about how to efficiently and effectively integrate the patient's narrative into the electronic health record (EHR). The central hypothesis of this proposal is that the implementation of a patient-centered narrative intervention with patients with serious illness will result in improved patient-nurse communication and improved patient psychosocial and spiritual well-being.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
51

participants targeted

Target at P25-P50 for not_applicable heart-failure

Timeline
Completed

Started Oct 2019

Typical duration for not_applicable heart-failure

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 1, 2019

Completed
2 days until next milestone

First Submitted

Initial submission to the registry

October 3, 2019

Completed
5 days until next milestone

First Posted

Study publicly available on registry

October 8, 2019

Completed
2.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 22, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 22, 2022

Completed
Last Updated

April 10, 2023

Status Verified

April 1, 2023

Enrollment Period

2.7 years

First QC Date

October 3, 2019

Last Update Submit

April 6, 2023

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change in Quality of Communication: QOC (Quality of Communication) survey

    The QOC survey assesses patients' perceptions of the quality of communication with nurses. The QOC was initially developed from qualitative interviews and focus groups with diverse set of patients, families and providers. The QOC has 19 items, with scores ranging from 0 (worst) to 10 (best). Internal consistency reliability and construct validity of the QOC has been established across several illness groups, and the QOC survey's responsiveness to communication interventions has been demonstrated by changes in pre- and post-intervention scores.

    Time 1= Baseline, Time 2= 24-48 hours after baseline, Time 3- 24-48 hours after Time 2

Secondary Outcomes (2)

  • Change in Patient-Reported Outcomes Measurement Information System (PROMIS)- 29 Profile

    Time 1= Baseline, Time 2= 24-48 hours after baseline, Time 3- 24-48 hours after Time 2

  • Change in Patient-Reported Outcome Measurement Information-System (PROMIS)- Psychosocial Illness Impact

    Time 1= Baseline, Time 2= 24-48 hours after baseline, Time 3- 24-48 hours after Time 2

Study Arms (2)

Narrative Intervention Group

EXPERIMENTAL

Patients in the narrative intervention group will participate in an interview and the resulting narrative will be uploaded to the electronic medical record. This group will also complete outcome measures (questionnaires) and exit interview.

Behavioral: Narrative Intervention

Usual Care Group

NO INTERVENTION

Patients in the usual care group will complete outcome measures (questionnaires) and exit interview only.

Interventions

Research staff conducts an open-ended, audio-recorded interview with the patient about their illness and how this illness has affected their psycho-social-spiritual well-being. The investigators will use the interview transcription to create a meta-narrative, which is then uploaded to the electronic medical record and the patient's primary nurse is notified that it is available to read.

Narrative Intervention Group

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18 years or older.
  • Has ability to read English.
  • Capable of giving informed consent.
  • Has diagnosis of at least one serious illness. For this study, the eligible diagnoses include: 1) New York Heart Class III or IV heart failure and/or 2) dialysis-dependent renal failure

You may not qualify if:

  • \- None.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Colorado Hospital

Aurora, Colorado, 80045, United States

Location

Related Publications (2)

  • Coats H, Shive N, Adrian B, Doorenbos AZ, Schmiege SJ. Integration of Person-Centered Narratives Into the Electronic Health Record. Nurs Res. 2023 Nov-Dec 01;72(6):421-429. doi: 10.1097/NNR.0000000000000680. Epub 2023 Aug 3.

  • Coats H, Shive N, Doorenbos AZ, Schmiege SJ. Integration of Person-Centered Narratives Into the Electronic Health Record: Study Protocol. Nurs Res. 2020 Nov/Dec;69(6):483-489. doi: 10.1097/NNR.0000000000000463.

MeSH Terms

Conditions

Heart FailureRenal Insufficiency

Condition Hierarchy (Ancestors)

Heart DiseasesCardiovascular DiseasesKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital Diseases

Study Officials

  • Heather Coats, PhD, APRN-BC

    University of Colorado, Denver

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Masking Details
Assigned group is not masked. All roles will know which group (narrative or usual care) the patient has been assigned to.
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Model Details: 50% of patient participants will complete the narrative intervention and outcome measures. 50% will complete outcome measures only.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 3, 2019

First Posted

October 8, 2019

Study Start

October 1, 2019

Primary Completion

June 22, 2022

Study Completion

June 22, 2022

Last Updated

April 10, 2023

Record last verified: 2023-04

Data Sharing

IPD Sharing
Will share

The final data set will include de-identified self-reported demographic and behavioral data from self-report, questionnaires, and interviews. The de-identified data and associated documentation will be made available to the community of scientists interested in palliative care as described in "access criteria." Additionally, aggregate, de-identified results will be submitted to ClinicalTrials.gov no later than one year after the trial's primary completion date.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
Time Frame
Up to ten years
Access Criteria
The data and associated documentation will be made available to users only under a data-sharing agreement that provides for (a) a commitment to using the data only for research purposes and not to identify any individual patient; (b) a commitment to securing the data using appropriate computer technology; and (c) a commitment to destroying or returning the data after analyses are completed. Such a data-use agreement will be executed through the PI. The database of demographic and patient reported outcomes and de-identified transcripts will only be accessed via the investigator's secure website or shared via encrypted delivery.

Locations