Removing Transfusion Dependence as a Barrier to Hospice Enrollment

Completed · Not applicable

Conditions studied: Hematologic Malignancy, Myelodysplastic Syndromes, Acute Myeloid Leukemia, Lymphoma, Leukemia, Myeloma

In brief

Hospice care at the end of life (EOL) includes a multidisciplinary team that helps patients and families focus on symptom control and quality of life. For patients with "solid" (e.g. lung, breast) cancers it has been shown to improve quality of life for both patients and families. Unfortunately, patients with blood cancers (e.g. leukemia, lymphoma) often delay their enrollment and receive more aggressive care at the EOL. One factor in this delay is the inability for patients to receive blood transfusions while on hospice. Patients with blood cancers often require frequent blood transfusions near the EOL for symptom control. The structure of Medicare hospice benefit makes coverage for transfusions financially unfeasible for hospice agencies, and therefore patients with blood cancers will delay enrollment onto hospice in order to continue to receive blood transfusions. The objective of this study is to evaluate whether removing this financial burden, through external funding of blood transfusions for patients while on hospice, will encourage patients with blood cancers to enroll on hospice earlier and ultimately improve their and their caregivers EOL care.

Key facts

Study ID

NCT05063591

Run by

Adam Olszewski

People needed

18

Starts

2021-07-09

Expected to finish

2023-12-31

Last updated by the study team

2026-01-15

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Aged 18 and older
• Advanced hematologic malignancies
• Hospice eligible as determined by their primary hematologist
• Have opted to forego further cancer-directed therapy.
• Transfusion Dependent: Requiring at least 2 units of blood products

You may not qualify if…

• Patients with major psychiatric illness
• Patients without the ability to speak and read English

Where it is running

• Rhode Island Hospital — Providence, Rhode Island, United States

Full record on ClinicalTrials.gov

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