The Effectiveness of the Liverpool Care Pathway (LCP)

This study is currently recruiting participants. (see Contacts and Locations)
Verified June 2013 by End-of-Life Research Group
Sponsor:
Collaborator:
Agentschap voor Innovatie door Wetenschap en Technologie
Information provided by (Responsible Party):
End-of-Life Research Group
ClinicalTrials.gov Identifier:
NCT01890239
First received: June 24, 2013
Last updated: June 27, 2013
Last verified: June 2013
  Purpose

Demographic trends coupled with a rise in chronic diseases mean that the population of patients requiring palliative and end-of-life care is ageing. Due to the ageing population palliative care for older people has been identified as one of the worldwide public health priorities.

A majority of elderly patients die in hospital. Studies from the United Kingdom and other countries have shown that many older persons dying in hospital experience suboptimal care.

To improve the quality of care at the end of life several countries have developed and piloted care pathways for dying patients. The Liverpool Care Pathway (LCP) was developed to transfer the best quality of care for the imminent dying from the hospice into other healthcare settings, so that wherever a person is dying quality terminal care can be provided.

Although the LCP has been adopted in 21 countries outside the United Kingdom and has been recognized to be the gold standard for practice, the evidence supporting such practice is insufficient. In a Cochrane review some qualitative and uncontrolled before-after studies are mentioned but no eligible RCTs, quasi-experimental studies or controlled before and after studies could be identified. Due to the scarce of available evidence, recommendations for the use of end-of-life pathways in caring for the dying cannot be made at the present time. RCTs or other well designed controlled studies are thus needed to obtain additional evidence about the effectiveness of the LCP.

We will contribute substantially to the increase of evidence for the effect of the Liverpool Care Pathway on end-of-life care in elderly patients dying in acute geriatric hospital wards in Flanders. A cluster randomized controlled trial (cluster RCT) model for the study will be used.

The aim of this cluster RCT is to evaluate the effectiveness of the Flemish LCP in improving the quality of care and quality of life during the last 48 hours of life of patients dying in acute geriatric hospital wards in Flanders as compared to usual care.


Condition Intervention
Quality of Life
Content of Care
Other: Liverpool Care Pathway for the Dying Patient

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Subject)
Primary Purpose: Health Services Research
Official Title: Improving End-of-life Care in Acute Geriatric Hospital Wards: a Cluster Randomized Trial of the Liverpool Care Pathway

Resource links provided by NLM:


Further study details as provided by End-of-Life Research Group:

Primary Outcome Measures:
  • The quality of life and quality of care during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]
    From each deceased geriatric patient - who has given informed consent to the nurse - a questionnaire will be filled in by a nurse, a physician and a family caregiver. Those three proxy measurements incorporate information about the quality of life and care during the last 48 hours of life of the geriatric patient.


Secondary Outcome Measures:
  • Symptom prevalence and symptom burden during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]
    This will be measured by a nurse and family caregiver through two different questionnaires.

  • Medications prescribed and administered during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]
    This will be measured by a physician through a questionnaire.

  • Medical and nursing interventions during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]
    This will be measured by a nurse and physician through two different questionnaires.

  • Communication among clinical staff and between clinical staff and patients/relatives during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]
  • The level of satisfaction of the relatives with the delivered end-of-life care during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]
    This will be measured by a family caregiver a questionnaire.

  • Level of bereavement of the relatives of patients who died in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]
    This will be measured by a family caregiver through a questionnaire.


Estimated Enrollment: 600
Study Start Date: September 2012
Estimated Primary Completion Date: March 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Use of the Liverpool Care Pathway for the Dying Patient
The Liverpool Care Pathway for the Dying Patient will be used for each geriatric patient, for who the multidisciplinary team has decided that he or she has entered the dying phase.
Other: Liverpool Care Pathway for the Dying Patient
The Liverpool Care Pathway for the Dying Patient is an integrated care pathway transferring the best quality of care for the imminent dying from the hospice into other healthcare settings, so that wherever a person is dying quality terminal care can be provided.
No Intervention: Usual care
Care will be provided as usual, also for patients who have entered the dying phase.

  Eligibility

Ages Eligible for Study:   60 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • patient is admitted to an acute geriatric hospital ward
  • patient is hospitalized for more than 48 hours
  • patient has given informed consent
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01890239

Contacts
Contact: Rebecca Verhofstede, Junior Researcher 09 332 11 83 rebecca.verhofstede@vub.ac.be

Locations
Belgium
St Lucas Brugge Recruiting
Brugge, Belgium
Contact: Rebecca Verhofstede         
St Jan Brugge Recruiting
Brugge, Belgium
Contact: Rebecca Verhofstede         
AZ Sint Blasius Recruiting
Dendermonde, Belgium
Contact: Rebecca Verhofstede         
Jessa Ziekenhuis Hasselt Recruiting
Hasselt, Belgium
Contact: Rebecca Verhofstede         
Sint Jozefskliniek Izegem Recruiting
Izegem, Belgium
Contact: Rebecca Verhofstede         
AZ Lokeren Recruiting
Lokeren, Belgium
Contact: Rebecca Verhofstede         
H. Hartziekenhuis Menen Recruiting
Menen, Belgium
Contact: Rebecca Verhofstede         
Sin Rembertziekenhuis Torhout Recruiting
Torhout, Belgium
Contact: Rebecca Verhofstede         
Sint Augustinuskliniek Veurne Recruiting
Veurne, Belgium
Contact: Rebecca Verhofstede         
Sponsors and Collaborators
End-of-Life Research Group
Agentschap voor Innovatie door Wetenschap en Technologie
  More Information

No publications provided

Responsible Party: End-of-Life Research Group
ClinicalTrials.gov Identifier: NCT01890239     History of Changes
Other Study ID Numbers: B143201213985
Study First Received: June 24, 2013
Last Updated: June 27, 2013
Health Authority: Belgium: Ethics Committee

ClinicalTrials.gov processed this record on August 01, 2014