Expanding Access to Home-Based Palliative Care: A Randomized Controlled Trial Protocol
| Autor: | Richard Brumley, Melissa Mert, Torrie Fields, Susan Enguidanos, Michael W. Rabow, Anna N. Rahman, Wendy J. Mack |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Palliative care media_common.quotation_subject Medicare Advantage California law.invention 03 medical and health sciences Pulmonary Disease Chronic Obstructive 0302 clinical medicine Randomized controlled trial 030502 gerontology law Neoplasms Health care Outcome Assessment Health Care Medicine Humans General Nursing media_common Aged Aged 80 and over Heart Failure Primary Health Care business.industry Palliative Care General Medicine Emergency department Caregiver burden Middle Aged Payment Home Care Services Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Family medicine Anxiety Female medicine.symptom 0305 other medical science business |
| Zdroj: | Journal of palliative medicine. 22(S1) |
| ISSN: | 1557-7740 |
| Popis: | Introduction: Studies show that home-based palliative care (HBPC) improves participant outcomes and satisfaction with care while also decreasing hospitalizations and emergency department visits. U.S. health care payment reforms create financial opportunities to offer HBPC. Consequently, more HBPC programs are emerging, heightening the need to evaluate their effectiveness. Methods: This randomized, controlled trial is comparing the effectiveness of an evidence-based model of HBPC and enhanced usual primary care for participants who receive primary care from medical groups and clinics organized under an accountable care organization or Medicare Advantage plan. Palliative care services are reimbursed by our partnering health plan provider. The five-year trial will enroll 1155 seriously ill participants (and ∼884 of their caregivers) with heart failure, chronic obstructive pulmonary disease, or advanced cancer. We are collecting data via telephone surveys with participants at baseline and one and two months postenrollment and with caregivers at baseline, one and two months postenrollments, and following the death of a loved one. We are collecting participant-reported outcome measures of pain, symptoms, anxiety, depression, participant-provider communication, and hope. Caregiver outcome measures include caregiver burden, communication with providers, anxiety, and depression. Additional outcomes are participant survival time and participants' emergency department visits and hospitalizations. Study Implementation: Challenges and Contributions: Our research team has encountered several significant challenges in early study implementation. These include engaging primary care providers in the study and coordinating logistics with a health plan. Both challenges have contributed to a lag in participant enrollment. Despite these challenges, our study holds tremendous promise to accelerate adoption and spread of an evidence-based HBPC model across the country. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|