Emergency Medicine Palliative Care Access

Completed · Not applicable

Conditions studied: Advanced Cancer, End Stage Organ Failure

In brief

This is a two-arm, multi-site randomized controlled trial of 1,350 older adults (50+ years) with either advanced cancer (defined as metastatic solid tumor) or poor prognosis end-stage organ failure (New York Heart Association (NYHA) Class III or IV Congestive Heart Failure (CHF), End-Stage Renal Disease (ESRD), defined as Glomerular Filtration Rate (GFR) \< 15 ml/min/m2 or dialysis ; or Global Initiative for Chronic Obstructive Lung Disease (GOLD) Stage III or higher, or oxygen-dependent chronic obstructive pulmonary disease (COPD) who present to the Emergency Department (ED), along with 675 of their informal caregivers. Investigators will compare the effectiveness of two distinct palliative care models: a) nurse-led telephonic case management; and b) facilitated, outpatient specialty palliative care.

Key facts

Study ID

NCT03325985

Run by

NYU Langone Health

People needed

1606

Starts

2018-03-28

Expected to finish

2023-08-24

Last updated by the study team

2025-01-13

Who can join

Age: 50 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patients:
• English or Spanish-speaking patients ages 50 years and older
• Qualifying serious, life-limiting conditions and who are scheduled for ED discharge, observation status, or admission for two midnights or less.
• Qualifying conditions include: advanced cancer (defined as metastatic solid tumor) or poor prognosis end-stage organ failure New York Heart Association (NYHA) Class III or IV Congestive Heart Failure (CHF), End-Stage Renal Disease (ESRD), defined as Glomerular Filtration Rate (GFR) < 15 ml/min/m2 or dialysis; or Global Initiative for Chronic Obstructive Lung Disease (GOLD) Stage III or higher or stage III or IV, or oxygen-dependent chronic obstructive pulmonary disease (COPD) defined as Global Initiative for Chronic Obstructive Lung Disease (GOLD)
• Patients must have health insurance, reside within the geographical area, and have a working telephone.
• Informal Caregivers:
• English or Spanish-speaking primary caregivers (relative or friend who has contact with the patient at least two times per week) ages 18 years and older.

You may not qualify if…

• Patients with dementia identified in the EHR, who received hospice services in the last six months, who have received 2 or more palliative care visits in the last 6 months, and those who reside in a skilled nursing or assisted living facility, or chronic care hospital.

Where it is running

• University of California, Los Angeles Ronald Reagan Medical Center — Los Angeles, California, United States
• University of California Irvine Medical Center — Orange, California, United States
• University of California San Diego Medical Center — San Diego, California, United States
• Yale University — New Haven, Connecticut, United States
• University of Florida (UF) — Gainesville, Florida, United States
• Northwestern Memorial Hospital — Chicago, Illinois, United States
• Rush University Medical Center — Chicago, Illinois, United States
• Brigham and Women's Hospital/Dana-Farber Cancer Institute — Boston, Massachusetts, United States
• Henry Ford Health System — Detroit, Michigan, United States
• Beaumont Health — Royal Oak, Michigan, United States
• William Beaumont Hospital, Troy — Troy, Michigan, United States
• Hackensack University Medical Center — Hackensack, New Jersey, United States
• Atlantic Health System, Morristown Medical Center — Morristown, New Jersey, United States
• NYU Langone Hospital- Brooklyn — Brooklyn, New York, United States
• NYU Langone Health Hospital Long Island — Mineola, New York, United States
• Bellevue Hospital — New York, New York, United States
• New York University Langone Tisch Hospital — New York, New York, United States
• Ohio State University (OSU) — Columbus, Ohio, United States

Full record on ClinicalTrials.gov

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