Cerebrovascular AccidentNCT00325611
Multidisciplinary Inpatient Palliative Care Intervention
A study testing Multidisciplinary palliative care team met with patient in people with Cerebrovascular Accident and Cancer, run by Kaiser Permanente at 1 site in United States.
Trial summary
Palliative care is believed to improve care of patients with life-limiting illnesses. This study evaluated the impact of a multi-center randomized trial of a palliative care team intervention on the quality and cost of care of hospitalized patients. Study subjects were randomized to intervention or usual care. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Cerebrovascular Accident, Cancer, Coronary Arteriosclerosis
- What is being tested?
- Multidisciplinary palliative care team met with patient
- Type of treatment
- Lifestyle or therapy programme
- How many people
- 550 participants
- Where
- 1 siteUnited States
- Study dates
- Apr 2002to Jul 2004
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults 18 years and older
- -admitted to acute inpatient care who had: (1) a medical diagnosis which was life-threatening, and (2) whose attending physician indicated they "would not be surprised if the patient died within one year".
Who cannot join
- 1) they had impaired cognitive status and no caregiver was available to provide consent, (2) were currently enrolled in hospice or other studies involving palliative care, (3) the attending physician did not approve study participation, or (4) their medical condition impaired participation (actively dying, too ill to participate) and no family member was available to provide consent.
Trial locations and contacts
1 site in 1 country.
United States1 site
Kaiser Permanente of Colorado
Aurora, Colorado, 80014
About this study
Official title: A Multi-Site Replication of an Inpatient Palliative Care Program
Palliative care is believed to improve care of patients with life-limiting illnesses. This study evaluated the impact of a multi-center randomized trial of a palliative care team intervention on the quality and cost of care of hospitalized patients. Study subjects were randomized to intervention or usual care. At study end, patients receiving the palliative care intervention reported greater patient satisfaction with their care. Intervention patients also had significantly fewer ICU admissions and lower total costs for care 6 months past their hospitalization. Intervention patients completed more advance directives and had longer hospice stays.
Read the detailed description
The Inpatient Palliative Care Service (IPCS) was implemented at three Kaiser-Permanente sites: Colorado, Portland and San Francisco. The service consisted of a physician, nurse, social worker, and spiritual counselor who worked with the study subjects randomized to receive the intervention. The intervention included symptom control, emotional and spiritual support, advance care and post-discharge care planning, There were no differences in symptom control or emotional support but IPCS patient reported better spiritual support compared to usual care patients. IPCS patients also reported greater satisfaction with their hospital care experience and better communication with their providers. Both IPCS and usual care patients reported improved quality of life during their enrollment hospital stay. IPCS patients completed more advance directives. IPCS patients had more home health visits than usual care patients but significantly fewer ICU admissions. IPCS patients had significantly lower hospital costs and higher pharmacy costs, than the usual care patients. IPCS patients had significantly lower (p= .001) total health services costs (a cost savings of $64.90 per patient per day) compared to usual care patients. This translated to an average total cost savings of $3,185 per enrolled patient. IPCS patients had a significantly longer average hospice length of stay. There were no differences between IPC and usual care patients in the proportion admitted to hospice, time to hospice admission, the average length of survival, or proportion of those who survived to 6 months.
Conclusion: IPCS resulted in better spiritual support, a better hospital care experience, better communication with their providers, increased completion of advance directives, fewer ICU admissions, longer hospice stays and reduced overall health care costs.
- Conditions
- Cerebrovascular Accident, Cancer, Coronary Arteriosclerosis, Heart Failure, Congestive, Diabetes Mellitus, Acquired Immunodeficiency Syndrome
- Being tested
- Multidisciplinary palliative care team met with patient
- Keywords
- Palliative care, End of life care
- Medical subject headings
- Stroke, Neoplasms, Coronary Artery Disease, Heart Failure, Diabetes Mellitus, Acquired Immunodeficiency Syndrome, Failure to Thrive, Pulmonary Disease, Chronic Obstructive
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Multidisciplinary palliative care team met with patientBehavioural
What is being measured
The primary outcome is the main question the study is designed to answer.
Quality and cost of care
Secondary outcomes (3)
Greater patient satisfaction
Lower ICU admissions
Lower total costs 6 months past hospitalization
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 May 2006 (estimated)
- Study startApr 2002
- Study completionJul 2004
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Cerebrovascular AccidentStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 550 participants
Sponsor and investigators
- Lead sponsor
- Kaiser Permanente
- Sponsor type
- University, hospital or other
- Collaborators
- Garfield Memorial Fund
- Investigators
- Ingrid M Venohr, RN, PhD, Study director, Kaiser PermanenteDouglas A Conner, PhD, Principal investigator, Kaiser Permanente Northwest RegionMarcia Liberson, MSW,MPH, Principal investigator, Kaiser-Permanente Northwest Region
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00325611
- Sponsor's protocol ID
- CO-02GGade-01 - H
- Other IDs
- NW-02RRich-01
- Status last verified
- May 2006
- First submitted
- 12 May 2006
- Last updated
- 15 May 2006
- Results posted
- No
Publications
Conner D. Differences in survival, hospice admission, and hospice length of stay for patients randomized to either an inpatient palliative care team intervention or to usual care. Poster presentation at the American Geriatrics Society Annual Meeting. May 2005.
Conner D, McGrady K, Richardson R, Beane J. Predictors of Hospice Admission and Length of Stay from a Randomized Control Trial of an Inpatient Palliative Care Service. Paper presentation at the American Academy of Hospice and Palliative Medicine annual meeting. February 2006, Nashville, TN.
McGrady K, Conner D, Richardson R, Beane J, Connors L, Rastrelli A, Collins T. Influence of an Inpatient Palliative Care Team on Service Utilization and Costs. Paper presentation at the American Academy of Hospice and Palliative Medicine annual meeting. February 2006, Nashville, TN.
Ryan RE, Connolly M, Bradford NK, Henderson S, Herbert A, Schonfeld L, Young J, Bothroyd JI, Henderson A. Interventions for interpersonal communication about end of life care between health practitioners and affected people. Cochrane Database Syst Rev. 2022 Jul 8;7(7):CD013116. doi: 10.1002/14651858.CD013116.pub2.
PubMed 35802350Gade G, Venohr I, Conner D, McGrady K, Beane J, Richardson RH, Williams MP, Liberson M, Blum M, Della Penna R. Impact of an inpatient palliative care team: a randomized control trial. J Palliat Med. 2008 Mar;11(2):180-90. doi: 10.1089/jpm.2007.0055.
PubMed 18333732
Study at a glance
From the registry record, last updated by the sponsor on 15 May 2006. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multi-Site Replication of an Inpatient Palliative Care Program
- ClinicalTrials.gov ID
- NCT00325611
- Acronym / sponsor ID
- CO-02GGade-01 - H
- Conditions
- Cerebrovascular Accident, Cancer, Coronary Arteriosclerosis, Heart Failure, Congestive, Diabetes Mellitus, Acquired Immunodeficiency Syndrome
- Keywords
- Palliative care, End of life care
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 550 participants
- Lead sponsor
- Kaiser PermanenteUniversity, hospital or other
- Collaborators
- Garfield Memorial Fund
- Study start
- Apr 2002
- Study completion
- Jul 2004
- First posted
- 15 May 2006 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Palliative care is believed to improve care of patients with life-limiting illnesses. This study evaluated the impact of a multi-center randomized trial of a palliative care team intervention on the quality and cost of care of hospitalized patients. Study subjects were randomized to intervention or usual care. At study end, patients receiving the palliative care intervention reported greater patient satisfaction with their care. Intervention patients also had significantly fewer ICU admissions and lower total costs for care 6 months past their hospitalization. Intervention patients completed more advance directives and had longer hospice stays.
Detailed description
The Inpatient Palliative Care Service (IPCS) was implemented at three Kaiser-Permanente sites: Colorado, Portland and San Francisco. The service consisted of a physician, nurse, social worker, and spiritual counselor who worked with the study subjects randomized to receive the intervention. The intervention included symptom control, emotional and spiritual support, advance care and post-discharge care planning, There were no differences in symptom control or emotional support but IPCS patient reported better spiritual support compared to usual care patients. IPCS patients also reported greater satisfaction with their hospital care experience and better communication with their providers. Both IPCS and usual care patients reported improved quality of life during their enrollment hospital stay. IPCS patients completed more advance directives. IPCS patients had more home health visits than usual care patients but significantly fewer ICU admissions. IPCS patients had significantly lower hospital costs and higher pharmacy costs, than the usual care patients. IPCS patients had significantly lower (p= .001) total health services costs (a cost savings of $64.90 per patient per day) compared to usual care patients. This translated to an average total cost savings of $3,185 per enrolled patient. IPCS patients had a significantly longer average hospice length of stay. There were no differences between IPC and usual care patients in the proportion admitted to hospice, time to hospice admission, the average length of survival, or proportion of those who survived to 6 months.
Conclusion: IPCS resulted in better spiritual support, a better hospital care experience, better communication with their providers, increased completion of advance directives, fewer ICU admissions, longer hospice stays and reduced overall health care costs.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- None (open label)
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Adults 18 years and older
- -admitted to acute inpatient care who had: (1) a medical diagnosis which was life-threatening, and (2) whose attending physician indicated they "would not be surprised if the patient died within one year".
Key exclusion criteria (1 listed)
- 1) they had impaired cognitive status and no caregiver was available to provide consent, (2) were currently enrolled in hospice or other studies involving palliative care, (3) the attending physician did not approve study participation, or (4) their medical condition impaired participation (actively dying, too ill to participate) and no family member was available to provide consent.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Multidisciplinary palliative care team met with patient | Behavioural | – |
Primary outcome
Quality and cost of care
3 secondary outcomes
Greater patient satisfaction
Lower ICU admissions
Lower total costs 6 months past hospitalization
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 May 2006.
- Results publicationConner D. Differences in survival, hospice admission, and hospice length of stay for patients randomized to either an inpatient palliative care team intervention or to usual care. Poster presentation at the American Geriatrics Society Annual Meeting. May 2005.
- Results publicationConner D, McGrady K, Richardson R, Beane J. Predictors of Hospice Admission and Length of Stay from a Randomized Control Trial of an Inpatient Palliative Care Service. Paper presentation at the American Academy of Hospice and Palliative Medicine annual meeting. February 2006, Nashville, TN.
- Results publicationMcGrady K, Conner D, Richardson R, Beane J, Connors L, Rastrelli A, Collins T. Influence of an Inpatient Palliative Care Team on Service Utilization and Costs. Paper presentation at the American Academy of Hospice and Palliative Medicine annual meeting. February 2006, Nashville, TN.
- Derived from this study: PubMed 35802350Ryan RE, Connolly M, Bradford NK, Henderson S, Herbert A, Schonfeld L, Young J, Bothroyd JI, Henderson A. Interventions for interpersonal communication about end of life care between health practitioners and affected people. Cochrane Database Syst Rev. 2022 Jul 8;7(7):CD013116. doi: 10.1002/14651858.CD013116.pub2.
- Derived from this study: PubMed 18333732Gade G, Venohr I, Conner D, McGrady K, Beane J, Richardson RH, Williams MP, Liberson M, Blum M, Della Penna R. Impact of an inpatient palliative care team: a randomized control trial. J Palliat Med. 2008 Mar;11(2):180-90. doi: 10.1089/jpm.2007.0055.
Related trials for Cerebrovascular Accident
Recruiting
Delay AvoIding Primary Evaluation for ThRombectomy of Acute StrokE Patients With Large Vessel OCclusion in the Angiography SuiTe
Stroke, Acute
RecruitingPhase 4
Xeomin® and Gait Related Mobility After Stroke
Stroke
RecruitingObservational study
Implementing Transcranial Direct Current Stimulation in a Rehabilitation Setting
Aphasia, Stroke
Not yet recruiting
EEG Feedback-Based Vagus Nerve Stimulation for Post-Stroke Dysphagia
Ischemic Stroke, Post-stroke Dysphagia
RecruitingObservational study
Development and Validation of Risk Prediction Models for Stroke and Cognitive Impairment in Moyamoya Disease and Moyamoya Syndrome
Moyamoya Disease, Moyamoya Syndrome
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ingrid M Venohr, RN, PhD study director
Kaiser Permanente
Douglas A Conner, PhD principal investigator
Kaiser Permanente Northwest Region
Marcia Liberson, MSW,MPH principal investigator
Kaiser-Permanente Northwest Region
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Multidisciplinary palliative care team met with patient in people with Cerebrovascular Accident and Cancer, run by Kaiser Permanente at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 May 2006. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Quality and cost of care. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00325611, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 May 2006.