- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06362239
Prospective Home-Based Palliative Care and Hospice Study
Prospective Analysis of the Impact of Home-Based Palliative Care and Hospice Compared to Inpatient and Clinic Based Palliative Care
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Identify difference in outcomes between those that receive home-based hospice and palliative care (HBHPC) in conjunction with inpatient and clinic based palliative care compared to those who receive only inpatient and clinic based palliative care. Outcomes analyzed will include hospital utilization including ICU days, inpatient hospital days, ED visits, quality of life as defined by the individual and/or primary caregivers through PEDSQL2 Family Impact Module survey, and delivery of goal concordant care by individual and family.
This is a prospective, multi-site, quasi-experimental design using an untreated comparison group with dependent pretest and posttest samples. This trial is being carried out at five sites including: Nationwide Children's Hospital (lead/primary site; Columbus, OH), Akron Children's Hospital (Akron, OH), Texas Children's Hospital (Houston, TX), Nemours Hospital (Wilmington, DE), and Medical University of South Carolina (Charleston, SC). The experimental group consists of all participants from sites with high-access HBHPC programs and the untreated comparison group consisting of all participants from sites with low-volume HBHPC. Protocols, consistent across all sites, are being submitted independently to the site's respective IRB for review and approval. The intent is to pool deidentified data for aggregate analysis by NCH.
This non-random design is selected because it is neither logistically feasible nor clinically ethical to conduct a randomized trial in which some participants would be allocated to not receive the intervention (HBHPC). Use of a pretest and comparison group minimizes threats to validity; the lack of randomization allows the potential for selection bias. However, we anticipate that given the diagnostic and clinical diversity of the sample, and the dearth of HBHPC access for pediatric patients, that clinical acuity will naturally be matched between both cohorts.
At or within the first few weeks of completing informed consent, participants will complete the study surveys. Study staff will recontact participants every three months to recomplete the surveys using a REDCap link, or paper surveys sent and returned via participant's preferred method (and entered into REDCap by study staff).
At or within the first few weeks of completing informed consent, participants will complete the study surveys (PEDSQL2 Family Impact Module Quality of Life survey and Goal Concordant Care survey). Study staff will recontact participants in three month intervals for a two year period or patient death if death occurs within study period to recomplete the surveys using a REDCap link, or paper surveys sent and returned, or completed by phone call via participant's preferred method (and entered into REDCap by study staff). NCH staff will create the REDCap, and give the template to each site for consistency purposes. Study staff will collect clinical and demographic information from the electronic medical record. Study staff will securely transfer site REDCap clinical, demographic, and survey data to the primary site (NCH) for analysis. Each site PI or CRC will complete their own patient follow up for survey completion. Any identifiable information will be stored separately from the study data and only PIs and coordinators at each site will have access to their own access to PHI. Aggregate data will be reviewed as a whole.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Catherine Roth, MPH
- Phone Number: 614-722-2997
- Email: catherine.roth@nationwidechildrens.org
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients aged 0-19
- Patients seen as new referral or follow up visit by PPC (Pediatric Palliative Care) team in either the inpatient or clinic context and expected to require at least twice-annual palliative care visits
Exclusion Criteria:
- Followed by PPC regardless of context for >6 months prior to enrollment
- Patient no longer clinically needs long term PPC follow up
- Child / young adult is in custody of state or county
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
High-access home-based hospice and palliative care (HBHPC)
Patients with high-access to home-based hospice and palliative care (HBHPC) enrolled from three sites: Nationwide Children's Hospital, Columbus, OH (NCH); Akron Children's Hospital, Akron, OH (ACH); and Medical University of South Carolina, Charleston, SC (MUSC).
|
Participants will complete study surveys as their participation in the research study.
Study staff will collect clinical and demographic information from the electronic medical records.
The enrollment in this intervention will not be decided by research enrollment, but would naturally occur regardless of enrollment in the study.
|
Low-access home-based hospice and palliative care (HBHPC)
Patients with low-access to home-based hospice and palliative care (HBHPC) (i.e., primarily or exclusively hospital-based services) enrolled from two sites: Nemours Children's Hospital, Wilmington, DE (Nemours); and Texas Children's Hospital, Houston, TX (TCH).
|
Participants will complete study surveys as their participation in the research study.
Study staff will collect clinical and demographic information from the electronic medical records.
The enrollment in this intervention will not be decided by research enrollment, but would naturally occur regardless of enrollment in the study.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hospital Utilization Differences
Time Frame: At enrollment and every three months for a two year period for a maximum of 24 months
|
Hospital utilization including ICU days, inpatient hospital days, ED visits, quality of life
|
At enrollment and every three months for a two year period for a maximum of 24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Demographic Differences
Time Frame: Identified at time of study enrollment and does not require ongoing measurement.
|
Differences in demographics including but not limited to diagnosis, age, race/ethnicity
|
Identified at time of study enrollment and does not require ongoing measurement.
|
Location of death differences
Time Frame: From date of enrollment to date of death (if occurred) over study enrollment for a maximum period of 24 months.
|
Differences in location of death.
|
From date of enrollment to date of death (if occurred) over study enrollment for a maximum period of 24 months.
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- STUDY00003853
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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