Emergency Medicine Palliative Care Access



Status:Recruiting
Conditions:Cancer, Cancer, Hospital
Therapuetic Areas:Oncology, Other
Healthy:No
Age Range:50 - Any
Updated:9/19/2018
Start Date:March 28, 2018
End Date:August 15, 2022
Contact:Jeanne Cho
Email:Jeanne.Cho@nyumc.org
Phone:212-263-1276

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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 end-stage organ failure
(New York Heart Association (NYHA) Class III and IV Heart Failure, End Stage Renal Disease
defined as GFR < 15 ml/min/m2; or Global Initiative for Chronic Obstructive Lung Disease
(GOLD) Stage III and higher or oxygen-dependent chronic obstructive pulmonary disease (COPD)
defined as FEV1 < 50% or the mMRC dyspnea scale) who present to the Emergency Department
(ED), along with 675 of their informal caregivers, to compare nurse-led telephonic case
management to facilitated, outpatient specialty palliative care. Investigators will compare
effectiveness of two distinct palliative care models that vary by provider type (nurse versus
physician-led) and mode of delivery (telephonic versus in-person): a) nurse-led telephonic
case management; and b) facilitated, outpatient specialty palliative care.


Inclusion Criteria:

Patients:

- English-speaking patients ages 50 years or older

- Qualifying serious, life-limiting conditions and who are scheduled for ED discharge,
observation status, or inpatient stay for two midnights or less will be eligible to
participate

- Qualifying conditions include: advanced cancer (defined as metastatic solid tumor) or
end-stage organ failure (New York Heart Association (NYHA) Class III and IV Heart
Failure, End Stage Renal Disease defined as GFR < 15 ml/min/m2; or Global Initiative
for Chronic Obstructive Lung Disease (GOLD) Stage III and higher or oxygen-dependent
chronic obstructive pulmonary disease (COPD) defined as FEV1 < 50% or the mMRC dyspnea
scale)

- Patients who are placed in observation overnight will still be eligible to participate
the following morning.

- Patients must have health insurance, reside within the geographical area, and have a
working telephone.

Informal Caregivers:

- English-speaking informal caregivers ages 18 years and older who accompany an
eligible, enrolled patient will be eligible to participate. Informal caregivers must
possess a working telephone.

Exclusion Criteria:

- Patient who are diagnosed with dementia, received hospice services in the last six
months, 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 and chronic care hospital.
We found this trial at
2
sites
Gainesville, Florida 32610
(352) 392-3261
Principal Investigator: Rebecca Murray, MD
Phone: 352-265-5911
University of Florida The University of Florida (UF) is a major, public, comprehensive, land-grant, research...
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550 1st Ave
New York, New York 10016
(212) 263-7300
Principal Investigator: Corita Grudzen, MD
Phone: 212-263-1276
New York University School of Medicine NYU School of Medicine has a proud history that...
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