Dataset Information

ProPACC: Protocol for a Trial of Integrated Specialty Palliative Care for Critically Ill Older Adults.

ABSTRACT:

Background

Each year, approximately one million older adults die in American intensive care units (ICUs) or survive with significant functional impairment. Inadequate symptom management, surrogates' psychological distress and inappropriate healthcare use are major concerns. Pioneering work by Dr. J. Randall Curtis paved the way for integrating palliative care (PC) specialists to address these needs, but convincing proof of efficacy has not yet been demonstrated.

Design

We will conduct a multicenter patient-randomized efficacy trial of integrated specialty PC (SPC) vs. usual care for 500 high-risk ICU patients over age 60 and their surrogate decision-makers from five hospitals in Pennsylvania.

Intervention

The intervention will follow recommended best practices for inpatient PC consultation. Patients will receive care from a multidisciplinary SPC team within 24 hours of enrollment that continues until hospital discharge or death. SPC clinicians will meet with patients, families, and the ICU team every weekday. SPC and ICU clinicians will jointly participate in proactive family meetings according to a predefined schedule. Patients in the control arm will receive routine ICU care.

Outcomes

Our primary outcome is patient-centeredness of care, measured using the modified Patient Perceived Patient-Centeredness of Care scale. Secondary outcomes include surrogates' psychological symptom burden and health resource utilization. Other outcomes include patient survival, as well as interprofessional collaboration. We will also conduct prespecified subgroup analyses using variables such as PC needs, measured by the Needs of Social Nature, Existential Concerns, Symptoms, and Therapeutic Interaction scale.

Conclusions

This trial will provide robust evidence about the impact of integrating SPC with critical care on patient, family, and health system outcomes.

SUBMITTER: Andersen SK

PROVIDER: S-EPMC9299559 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

ProPACC: Protocol for a Trial of Integrated Specialty Palliative Care for Critically Ill Older Adults.

Andersen Sarah K SK Vincent Grace G Butler Rachel A RA Brown Elke H P EHP Maloney Dave D Khalid Sana S Oanesa Rae R Yun James J Pidro Carrie C Davis Valerie N VN Resick Judith J Richardson Aaron A Rak Kimberly K Barnes Jackie J Bezak Karl B KB Thurston Andrew A Reitschuler-Cross Eva E King Linda A LA Barbash Ian I Al-Khafaji Ali A Brant Emily E Bishop Jonathan J McComb Jennifer J Chang Chung-Chou H CH Seaman Jennifer J Temel Jennifer S JS Angus Derek C DC Arnold Robert R Schenker Yael Y White Douglas B DB

Journal of pain and symptom management 20220601 6

<h4>Background</h4>Each year, approximately one million older adults die in American intensive care units (ICUs) or survive with significant functional impairment. Inadequate symptom management, surrogates' psychological distress and inappropriate healthcare use are major concerns. Pioneering work by Dr. J. Randall Curtis paved the way for integrating palliative care (PC) specialists to address these needs, but convincing proof of efficacy has not yet been demonstrated.<h4>Design</h4>We will con ...[more]

PMID: 35595373

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Dataset Information

ProPACC: Protocol for a Trial of Integrated Specialty Palliative Care for Critically Ill Older Adults.

Background

Design

Intervention

Outcomes

Conclusions

Publications

ProPACC: Protocol for a Trial of Integrated Specialty Palliative Care for Critically Ill Older Adults.

Similar Datasets

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