Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness

BMJ Open
Corita R GrudzenEMPallA Investigators

Abstract

Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement. This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease);...Continue Reading

Associated Clinical Trials

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Citations

Sep 6, 2019·Journal of Palliative Medicine·Corita R GrudzenUNKNOWN EMPallA Outpatient Investigators
May 13, 2020·Acute Medicine & Surgery·Naomi GeorgeKei Ouchi
Nov 28, 2020·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Mario Alberto de la Puente PachecoBriyis Fontecha Pacheco
Jan 25, 2021·Nursing Outlook·Audrey J TanUNKNOWN EMPallA Telephonic Working Group
Aug 7, 2021·Annals of Emergency Medicine·Anthony J LoffredoSangeeta Lamba
Aug 20, 2021·Journal of Pain and Symptom Management·Rahul M RegeLauren T Southerland
Mar 20, 2021·The European Respiratory Journal·Jennifer PhilipDavid Hui

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