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Operationalizing needs-focused palliative care for older adults in intensive care units: Design of and rationale for the PCplanner randomized clinical trial.

Publication ,  Journal Article
Cox, CE; Olsen, MK; Casarett, D; Haines, K; Al-Hegelan, M; Bartz, RR; Katz, JN; Naglee, C; Ashana, D; Gilstrap, D; Gu, J; Parish, A; Frear, A ...
Published in: Contemp Clin Trials
November 2020

INTRODUCTION: The number of older adults who receive life support in an intensive care unit (ICU), now 2 million per year, is increasing while survival remains unchanged. Because the quality of ICU-based palliative care is highly variable, we developed a mobile app intervention that integrates into the electronic health records (EHR) system called PCplanner (Palliative Care planner) with the goal of improving collaborative primary and specialist palliative care delivery in ICU settings. OBJECTIVE: To describe the methods of a randomized clinical trial (RCT) being conducted to compare PCplanner vs. usual care. METHODS AND ANALYSIS: The goal of this two-arm, parallel group mixed methods RCT is to determine the clinical impact of the PCplanner intervention on outcomes of interest to patients, family members, clinicians, and policymakers over a 3-month follow up period. The primary outcome is change in unmet palliative care needs measured by the NEST instrument between baseline and 1 week post-randomization. Secondary outcomes include goal concordance of care, patient-centeredness of care, and quality of communication at 1 week post-randomization; length of stay; as well as symptoms of depression, anxiety, and post-traumatic stress disorder at 3 months post-randomization. We will use general linear models for repeated measures to compare outcomes across the main effects and interactions of the factors. We hypothesize that compared to usual care, PCplanner will have a greater impact on the quality of ICU-based palliative care delivery across domains of core palliative care needs, psychological distress, patient-centeredness, and healthcare resource utilization.

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Published In

Contemp Clin Trials

DOI

EISSN

1559-2030

Publication Date

November 2020

Volume

98

Start / End Page

106163

Location

United States

Related Subject Headings

  • Public Health
  • Palliative Care
  • Intensive Care Units
  • Humans
  • General Clinical Medicine
  • Family
  • Communication
  • Anxiety
  • Aged
  • 42 Health sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cox, C. E., Olsen, M. K., Casarett, D., Haines, K., Al-Hegelan, M., Bartz, R. R., … Docherty, S. L. (2020). Operationalizing needs-focused palliative care for older adults in intensive care units: Design of and rationale for the PCplanner randomized clinical trial. Contemp Clin Trials, 98, 106163. https://doi.org/10.1016/j.cct.2020.106163
Cox, Christopher E., Maren K. Olsen, David Casarett, Krista Haines, Mashael Al-Hegelan, Raquel R. Bartz, Jason N. Katz, et al. “Operationalizing needs-focused palliative care for older adults in intensive care units: Design of and rationale for the PCplanner randomized clinical trial.Contemp Clin Trials 98 (November 2020): 106163. https://doi.org/10.1016/j.cct.2020.106163.
Cox CE, Olsen MK, Casarett D, Haines K, Al-Hegelan M, Bartz RR, et al. Operationalizing needs-focused palliative care for older adults in intensive care units: Design of and rationale for the PCplanner randomized clinical trial. Contemp Clin Trials. 2020 Nov;98:106163.
Cox, Christopher E., et al. “Operationalizing needs-focused palliative care for older adults in intensive care units: Design of and rationale for the PCplanner randomized clinical trial.Contemp Clin Trials, vol. 98, Nov. 2020, p. 106163. Pubmed, doi:10.1016/j.cct.2020.106163.
Cox CE, Olsen MK, Casarett D, Haines K, Al-Hegelan M, Bartz RR, Katz JN, Naglee C, Ashana D, Gilstrap D, Gu J, Parish A, Frear A, Krishnamaneni D, Corcoran A, Docherty SL. Operationalizing needs-focused palliative care for older adults in intensive care units: Design of and rationale for the PCplanner randomized clinical trial. Contemp Clin Trials. 2020 Nov;98:106163.
Journal cover image

Published In

Contemp Clin Trials

DOI

EISSN

1559-2030

Publication Date

November 2020

Volume

98

Start / End Page

106163

Location

United States

Related Subject Headings

  • Public Health
  • Palliative Care
  • Intensive Care Units
  • Humans
  • General Clinical Medicine
  • Family
  • Communication
  • Anxiety
  • Aged
  • 42 Health sciences