Improving the Quality of End-of-Life Communication for Patients With COPD

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00106080
First received: March 18, 2005
Last updated: February 6, 2014
Last verified: May 2008
  Purpose

The purpose of this study is to evaluate a multifaceted intervention to improve the quality of end-of-life communication between patients with COPD and their primary care providers using information about patients preferences for end of life care and how to communicate and use this information to activate patients, family members, and healthcare providers.


Condition Intervention
Pulmonary Disease
Palliative Care
Behavioral: Audit and Feedback

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Investigator)
Official Title: Improving the Quality of End-of-Life Communication for Patients With COPD

Resource links provided by NLM:


Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • Quality of Patient Clinician Communication About End-of-Life Care(QOC) score [ Time Frame: Measured at enrollment and post-intervention ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Effect of the intervention on self-reported end-of-life discussions between patient, reported independently by patient and provider, and patient and surrogate. Assess baseline desire for and the quality of end-of-life communication. [ Time Frame: Measured at enrollment and post-intervention ] [ Designated as safety issue: No ]

Estimated Enrollment: 400
Study Start Date: November 2004
Study Completion Date: May 2008
Primary Completion Date: May 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1
Provider and surrogate summaries of patient's preferences for health care communication and treatment.
Behavioral: Audit and Feedback
Individualized summaries of patient's preferences regarding communication about end-of-life care and preferences for end-of-life care to activate patients, family members, and healthcare providers.
No Intervention: Arm 2
Usual care

Detailed Description:

This project builds on previous work that described preferences important to patients at end-of-life and desire for life-sustaining therapy by incorporating these attributes into a multifaceted intervention designed to improve the quality of end-of-life communication.

Our specific aim is to evaluate a multifaceted intervention to improve the quality of end-of-life communication between patients with moderate or severe COPD and their primary care providers. The intervention is based on self-efficacy theory and includes provider education, local champions and role models, determination of patients individual barriers and facilitators regarding communication about end-of-life care, preferences for communication about end-of-life care and preferences for end-of-life care and using this information to activate patients, family members, and healthcare providers.

If successful, the methods used for this study could be translated into clinic practice and possibly generalized to other chronic life-threatening conditions

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

One or more of the following:

1 Have 3 or more outpatient clinics visits for COPD (ICD-9) in the two years prior to enrollment.

2. Have been hospitalized with a primary discharge diagnosis (ICD-9) for COPD in the two years prior to enrollment.

3. Active use of inhaled beta-agonist and ipratropium bromide (or equivalent in combination inhalers like Combivent) in the 12 months prior to enrollment.

Plus

  1. Have a future visit scheduled in one of the eligible primary care or chest clinics; and
  2. Have airflow limitation

Exclusion Criteria:

  1. If they have cognitive dysfunction, language barriers or severe psychiatric disorder that would preclude them from completing the questionnaires. This will be assessed initially by the patients provider and by the research assistant during in-person interviews.
  2. The provider taking care of their COPD does not participate.
  3. Have a new diagnosis of COPD within the last month.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00106080

Locations
United States, Washington
University of Washington
Seattle, Washington, United States, 98195
Sponsors and Collaborators
Investigators
Principal Investigator: David H Au, MD MS VA Puget Sound Health Care System, Seattle
  More Information

Publications:

Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00106080     History of Changes
Other Study ID Numbers: IIR 02-292
Study First Received: March 18, 2005
Last Updated: February 6, 2014
Health Authority: United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Communication
Paliative Care

Additional relevant MeSH terms:
Lung Diseases
Respiration Disorders
Respiratory Tract Diseases

ClinicalTrials.gov processed this record on April 22, 2014