Improving comfort around dying in elderly people: a cluster randomised controlled trial

Lancet
Kim BeernaertLuc Deliens

Abstract

Over 50% of elderly people die in acute hospital settings, where the quality of end-of-life care is often suboptimum. We aimed to assess the effectiveness of the Care Programme for the Last Days of Life (CAREFuL) at improving comfort and quality of care in the dying phase in elderly people. We did a cluster randomised controlled trial in acute geriatric wards in ten hospitals in Flemish Region, Belgium, between Oct 1, 2012, and March 31, 2015. Hospitals were randomly assigned to implementation of CAREFuL (CAREFuL group) or to standard care (control group) using a random number generator. Patients and families were masked to interventaion allocation; hospital staff were unmasked. CAREFuL comprised a care guide for the last days of life, training, supportive documentation, and an implementation guide. Primary outcomes were comfort around dying, measured with the End-of-Life in Dementia-Comfort Assessment in Dying (CAD-EOLD), and symptom management, measured with the End-of-Life in Dementia-Symptom Management (SM-EOLD), by nurses and family carers. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01890239. 451 (11%) of 4241 beds in ten hospitals were included in the analyses. Five ho...Continue Reading

Associated Clinical Trials

Citations

Nov 12, 2019·JAMA Internal Medicine·Lieve Van den BlockUNKNOWN PACE trial group
Jun 28, 2018·The American Journal of Hospice & Palliative Care·Yusuke KannoMitsunori Miyashita
Dec 7, 2018·F1000Research·Emily J GuerardNoelle K LoConte
May 23, 2019·International Journal of Palliative Nursing·Diana De, Carol Thomas
Jun 7, 2018·The American Journal of Hospice & Palliative Care·Felicity MoonDavid Kissane

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