Data from emergency medicine palliative care access (EMPallA): a randomized controlled trial comparing the effectiveness of specialty outpatient versus telephonic palliative care of older adults with advanced illness presenting to the emergency department

Autor:	Jeanne Cho, Mara Flannery, EMPallA Investigators, Keith Goldfeld, Corita R. Grudzen, Abigail M Schmucker
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Male Palliative care Kidney Disease law.invention 0302 clinical medicine Quality of life Randomized controlled trial law Functional decline Outpatients 80 and over Medicine 030212 general & internal medicine Lung Cancer Geriatrics Aged 80 and over Emergency Service RC952-1245 Loneliness Medical emergencies. Critical care. Intensive care. First aid Health Services Middle Aged End-stage organ failure Special situations and conditions 030220 oncology & carcinogenesis Emergency Medicine Female medicine.symptom Emergency Service Hospital Research Article medicine.medical_specialty Clinical Trials and Supportive Activities Clinical Sciences Medicare End stage renal disease 03 medical and health sciences Hospital Clinical Research Advanced cancer 7.2 End of life care Humans Aged Patient-reported outcomes business.industry RC86-88.9 Emergency department Emergency & Critical Care Medicine United States Telephone UCLA Loneliness Scale Emergency medicine EMPallA Investigators Management of diseases and conditions business
Zdroj:	BMC Emergency Medicine, Vol 21, Iss 1, Pp 1-11 (2021) BMC emergency medicine, vol 21, iss 1 BMC Emergency Medicine
Popis:	Background The Emergency Medicine Palliative Care Access (EMPallA) trial is a large, multicenter, parallel, two-arm randomized controlled trial in emergency department (ED) patients comparing two models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. This report aims to: 1) report baseline demographic and quality of life (QOL) data for the EMPallA cohort, 2) identify the association between illness type and baseline QOL while controlling for other factors, and 3) explore baseline relationships between illness type, symptom burden, and loneliness. Methods Patients aged 50+ years with advanced cancer (metastatic solid tumor) or end-stage organ failure (New York Heart Association Class III or IV heart failure, end stage renal disease with glomerular filtration rate 2, or Global Initiative for Chronic Obstructive Lung Disease Stage III, IV, or oxygen-dependent chronic obstructive pulmonary disease defined as FEV1 Results Between April 2018 and April 3, 2020, 500 patients were enrolled. On average, end-stage organ failure patients had lower QOL as measured by the FACT-G scale than cancer patients with an estimated difference of 9.6 points (95% CI: 5.9, 13.3), and patients with multiple conditions had a further reduction of 7.4 points (95% CI: 2.4, 12.5), when adjusting for age, education level, race, sex, immigrant status, presence of a caregiver, and hospital setting. Symptom burden and loneliness were greater in end-stage organ failure than in cancer. Conclusions The EMPallA trial is enrolling a diverse sample of ED patients. Differences by illness type in QOL, symptom burden, and loneliness demonstrate how distinct disease trajectories manifest in the ED. Trial registration Clinicaltrials.gov identifier: NCT03325985. Registered October 30, 2017.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::abbfa51288919d09137e40f05bfb3da5 https://doaj.org/article/041cac1c68354363a8aa80d20aee30c0 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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