LiverPAL: 진행성 간 질환 환자를 위한 입원 환자 완화 치료의 무작위 시험 (LiverPAL)
The goal of this clinical trial is to evaluate whether early integration of palliative care in the care of hospitalized patients with advanced liver disease (AdvLD) can improve patients' quality of life, physical symptoms, mood, and serious illness communication. Palliative care is a medical specialty focused on lessening (or "palliating") symptoms and assisting in coping with serious illness.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
상세 설명
The main purpose of this study is to compare two types of care - usual hepatology care and usual hepatology care with early involvement of palliative care clinicians to see which is better for improving the experience of hospitalized patients with advanced liver disease (AdvLD).
The investigators aim to find out whether introducing hospitalized patients with AdvLD to the palliative care team that specializes in symptom management can improve the quality of life and physical and psychological symptoms that patients and families experience during their hospitalizations as well as enhance the quality of patients' end of life care.
연구 유형
연구 유형
등록 (실제)
등록
단계
단계
- 해당 없음
연락처 및 위치
연구 장소
-
-
Massachusetts
-
Boston, Massachusetts, 미국, 02114
- Massachusetts General Hospital
-
-
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Patient Inclusion Criteria:
-
Hospitalized patient with a diagnosis of advanced liver disease, defined as cirrhosis with one of the following (new or ongoing) within the prior six months from date of consent:
- Ascites (requiring diuretics or serial large volume paracenteses)
- Spontaneous bacterial peritonitis
- Hepatic hydrothorax (requiring diuretics)
- Variceal bleed (with one or more occurrences)
- Overt hepatic encephalopathy (requiring medications)
-
Ability to comprehend English
Patient Exclusion Criteria:
- Prior history of liver transplantation
- Have uncontrolled hepatic encephalopathy, cognitive impairment, psychiatric disorder or other comorbid condition which the primary medical, hepatology, and/or transplant surgery teams believes prohibits the ability to provide informed consent
- Current or recent (within 5 years of receiving curative cancer treatment) history of extrahepatic malignancy (excluding non-melanoma skin cancer)
- Presence of hepatocellular carcinoma beyond Milan criteria
- Are already receiving hospice care
- Receive a score of <10 on the Simplified Animal Naming Test
Caregiver Inclusion Criteria
- Adult caregiver (≥ 18 years of age)
- A relative or friend identified by the patient upon whom the patient relies for help and who likely is to be present in-person during hospitalizations or clinic appointments, or willing to participate by phone
- Ability to comprehend English and can complete questionnaires
Caregiver Exclusion Criteria
1. Inability to comprehend English
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 지지 요법
- 할당: 무작위
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
팔의 수
무기와 개입
참가자 그룹 / 팔참가자 그룹 / 팔 |
개입 / 치료개입 / 치료 |
|---|---|
|
간섭 없음: Usual Hepatology Care
Usual hepatology care |
|
|
실험적: Usual Hepatology Care with Early Palliative Care
Usual hepatology care with early palliative care |
The intervention include integrating early palliative care with usual hepatology care to evaluate and treat patients' symptoms, enhance their illness and prognostic understanding, support their coping, and coordinate their serious illness, transitional, and end-of-life care. |
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Patient Quality of Life (Functional Assessment of Chronic Illness Therapy - Palliative Care, FACIT-Pal) up t0 4 weeks
기간: Up to 4 weeks
|
Compare patient quality of life (FACIT-Pal) scores up to 4 weeks adjusting for baseline quality of life scores between the study arms. Score range 0-184 with higher scores indicating better quality of life. |
Up to 4 weeks
|
2차 결과 측정
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Patient FACIT-Pal Score longitudinally between study arms
기간: Up to 6 months
|
Compare patient quality of life (FACIT-Pal) scores longitudinally between the study arms. Score range 0-184 with higher scores indicating better quality of life. |
Up to 6 months
|
|
Patient Symptom Burden (revised Edmonton Symptom Assessment Scale, ESAS-r)
기간: Up to 6 months
|
Compare patient symptom burden scores (ESAS-r) between the study arms. Score range 0-100 with higher scores indicating higher symptom burden. |
Up to 6 months
|
|
Patient Depression Symptoms (Hospital Anxiety and Depression Scale, HADS-D)
기간: Up to 6 months
|
Compare patient depression symptoms (HADS-D) between the study arms. Score range 0-21 with higher scores indicating higher depression symptoms. |
Up to 6 months
|
|
Patient Anxiety Symptoms (Hospital Anxiety and Depression Scale, HADS-A)
기간: Up to 6 months
|
Compare patient anxiety symptoms (HADS-A) between study arms. Score range 0-21 with higher scores indicating higher anxiety symptoms. |
Up to 6 months
|
|
Patient End-of-Life (EOL) Care Communication with Clinicians
기간: Final assessment prior to patient death or at 6 months
|
"Has [participant] talked with [participant's] doctor about the kind of medical care [participant] would want if [participant] were very sick or near the end of life?" |
Final assessment prior to patient death or at 6 months
|
|
Documentation of Patient End-of-Life (EOL) Care Preferences
기간: After patient death, up to 60 months
|
Compare documentation of EOL care preferences in the electronic health record between study arms since baseline. |
After patient death, up to 60 months
|
공동 작업자 및 조사자
협력자
협력자
수사관
수사관
- 수석 연구원: Nneka Ufere, MD MSCE, Massachusetts General Hospital
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
기타 연구 ID 번호
- 2023P001894
- 80736 (기타 보조금/기금 번호: Robert Wood Johnson Foundation)
- 242379 (기타 보조금/기금 번호: Cambia Health Foundation)
- 243432 (기타 보조금/기금 번호: American Association for the Study of Liver Diseases)
- 236965 (기타 보조금/기금 번호: Massachusetts General Hospital Executive Committee on Researrch)
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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