Comparing Optimized Models of Primary And Specialist Services for Palliative Care: Pilot Feasibility Trial

Completed · Not applicable

Conditions studied: Seriously Ill Hospitalized Patients

In brief

Palliative care (PC) seeks to reduce suffering and improve quality of life for patients with serious illnesses and their families. National guidelines recommend that clinicians either provide palliative care themselves (generalist PC) or consult experts (specialist PC) as a standard part of serious illness care. This feasibility pilot study will be conducted with 6 hospitals at two large U.S. health systems and enroll 540 seriously ill hospitalized patients. Eligibility is determined by a mortality prediction score where enrolled patients have at least a 60% risk of dying within 1 year. Enrollment assessment occurs as close as possible to 36 hours post admission. In this cluster-randomized trial, the 6 hospitals will be randomized to 3 arms: (1) standardized usual care, (2) trained generalist PC, or (3) specialist PC. Generalists are trained using the Center to Advance Palliative Care (CAPC) online trainings. The pilot study will only measure process outcomes to assess the feasibility of a larger clinical trial (e.g., are the interventions working as intended). This pilot feasibility study is the precursor to a much larger pragmatic, hybrid effectiveness-implementation parallel-cluster RCT that will assess the comparative effectiveness of triggering generalist PC and specialist PC on several patient-centered outcome measures.

Key facts

Study ID

NCT06629142

Run by

University of Pennsylvania

People needed

1208

Starts

2024-10-17

Expected to finish

2025-07-01

Last updated by the study team

2025-07-24

Who can join

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

You may qualify if…

• Age 18 years of age or older; AND
• Predicted 1-year mortality risk of 60% or greater; AND
• Admitted to a study hospital.

You may not qualify if…

• Patients who die or have an active or completed discharge order prior to enrollment time

Where it is running

• Kaiser Permanente Southern California — Pasadena, California, United States
• Trinity Health — Livonia, Michigan, United States

Full record on ClinicalTrials.gov

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