Improving the Quality of End-of-Life Communication for Patients With COPD
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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 |
- 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 ]
- 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 |
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
- Have a future visit scheduled in one of the eligible primary care or chest clinics; and
- Have airflow limitation
Exclusion Criteria:
- 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.
- The provider taking care of their COPD does not participate.
- Have a new diagnosis of COPD within the last month.
Contacts and Locations| United States, Washington | |
| VA Health Services Research and Development | |
| Seattle, Washington, United States, 98101 | |
| 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: | April 18, 2013 |
| 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 June 18, 2013