Improving end-of-life care in acute geriatric hospital wards using the Care Programme for the Last Days of Life: study protocol for a phase 3 cluster randomized controlled trial

BMC Geriatrics

Study Protocol

Nele Van Den Noortgate¹  Rebecca Verhofstede²  Joachim Cohen²  Tinne Smets²  Luc Deliens³  Massimo Costantini⁴ 

[1] Department of Geriatrics, Ghent University Hospital, Ghent, Belgium;End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium;End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium;Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium;Palliative Care Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy;

关键词: Cluster randomized controlled trial;    Terminal care;    Hospital;    Older people;   

DOI  :  10.1186/s12877-015-0010-7

 received in 2014-12-19, accepted in 2015-02-03,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe Care Programme for the Last Days of Life has been developed to improve the quality of end-of-life care in acute geriatric hospital wards. The programme is based on existing end-of-life care programmes but modeled to the acute geriatric care setting. There is a lack of evidence of the effectiveness of end-of-life care programmes and the effects that may be achieved in patients dying in an acute geriatric hospital setting are unknown. The aim of this paper is to describe the research protocol of a cluster randomized controlled trial to evaluate the effects of the Care Programme for the Last Days of Life.Methods and designA cluster randomized controlled trial will be conducted. Ten hospitals with one or more acute geriatric wards will conduct a one-year baseline assessment during which care will be provided as usual. For each patient dying in the ward, a questionnaire will be filled in by a nurse, a physician and a family carer. At the end of the baseline assessment hospitals will be randomized to receive intervention (implementation of the Care Programme) or no intervention. Subsequently, the Care Programme will be implemented in the intervention hospitals over a six-month period. A one-year post-intervention assessment will be performed immediately after the baseline assessment in the control hospitals and after the implementation period in the intervention hospitals. Primary outcomes are symptom frequency and symptom burden of patients in the last 48 hours of life.DiscussionThis will be the first cluster randomized controlled trial to evaluate the effect of the Care Programme for the Last Days of Life for the acute geriatric hospital setting. The results will enable us to evaluate whether implementation of the Care Programme has positive effects on end-of-life care during the last days of life in this patient population and which components of the Care Programme contribute to improving the quality of end-of-life care.Trial registrationClinicalTrials.gov Identifier: NCT01890239. Registered June 24th, 2013.

【 授权许可】

CC BY   
© Verhofstede et al.; licensee BioMed Central. 2015