Palliative Care Needs Among Elderly People at Emergency Department

Aim: To assess what proportion of all patients over the age of 75 who seek care at the emergency department have palliative care needs and whether these are documented in the patient's medical record.

Data collection and analysis: Patients over 75 years of age who seek care in an emergency department and are classified as triage 2-4 during initial triage are assessed by a researcher. Patients with dementia or other cognitive dysfunction will be excluded. Two types of data collection are included 1) Swedish Palliative care guide (S-PCG) documents that the researcher fills in together with the patient, 2) data from the patient's medical record, this data is collected according to a special assessment template. Data from the medical record will be collected after the patient left the emergency department.

Data collection is ongoing until 300 patients have been included in the study. Data will be analyzed using descriptive statistics.

Implications: The percentage of previously undetected/documented palliative care needs in emergency departments is relevant for prioritizing general palliative care within e.g. housing for the elderly and primary care S-PCG can be relevant to increase the level of knowledge at these care facilities. If it turns out that many patients have palliative care needs that are not met in the emergency department, health care structures need to ensure that these patients receive help at the right level of care. This would likely mean that the number of emergency visits and hospital admissions (with suffering and reduced quality of life as a result) can be reduced.

Study Overview

• Status: Recruiting
• Conditions: Palliative Care; Palliative Medicine; Elderly Person
• Intervention / Treatment: Other: Swedish Palliative Care Guide (S-PCG)

• Study Type: Observational
• Enrollment (Estimated): 300

Contacts and Locations

• Study Contact: Name: Sofia Persson, MSc, PhD-student; Phone Number: +46708652769; Email: sofia.persson@skane.se
• Study Contact Backup: Name: Christel Hedman, MD PhD; Email: christel.hedman@ki.se

Study Locations

• Sweden
  • Skane
    • Helsingborg, Skane, Sweden
      • Recruiting
      • Region Skåne
      • Contact: Sofia Persson, PhD-student; Email: sofia.persson@skane.se

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients admitted to emergency department in HBG Sweden, aged 75 and above and classified as triage 2-4, without cognitive dysfunction.

Description

Inclusion Criteria:

• Classified as triage 2-4

Exclusion Criteria:

• Dementia or other cognitive dysfunction
• Not being able to communicate in Swedish.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Descriptive patient group; The research nurse will fill in the documents in Swedish Palliative care guide (S-PCG) together with the patient.

Other: Swedish Palliative Care Guide (S-PCG); S-PCG is a care guide that aim to inform best practice and to meet palliative care needs of patients and their families throughout all the time with palliative care needs. The S-PCG support palliative care for adult patients regardless of diagnosis, place of care and if it is early och late palliative care. The S-PCG includes three parts; Assessments of palliative care needs; Initiating palliative care 2D. End of life care.; After death. In this study only the first part of the S-PCG will be used.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Palliative care needs	The proportion of patients that have palliative care needs that are identified with S-PCG.	The study will be ongoing fo up to at year. The S-PCG will be used at 1 time for each included patient.
Palliative care needs documented in medical records.	The proportion of patients with palliative care need identified with S-PCG as compared to the proportion of palliative care needs documented in the medical record.	The study will be ongoing fo up to at year. The S-PCG will be used at 1 time for each included patient

Collaborators and Investigators

• Sponsor: Region Skåne
• Investigators: Principal Investigator: Maria Schelin, ass. prof., Region Skåne

Study record dates

Study Major Dates

• Study Start (Actual): March 31, 2023
• Primary Completion (Estimated): December 30, 2024
• Study Completion (Estimated): December 31, 2025

Study Registration Dates

• First Submitted: March 20, 2023
• First Submitted That Met QC Criteria: May 31, 2023
• First Posted (Actual): June 1, 2023

Study Record Updates

• Last Update Posted (Actual): May 17, 2024
• Last Update Submitted That Met QC Criteria: May 16, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: Elderly; Emergency department; palliative care needs; Swedish Palliative Care Guide
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: 2020-05905

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No