Helping elderly patients discuss their end-of-life care preferences
Assessment of Shared Decision-making Tool for Eliciting Informed Goals of Care in the Hospitalized Elderly (ASKMEGOC): A Randomized Clinical Trial
This study is trying to see if helping elderly patients talk about their end-of-life care wishes can lead to better care and satisfaction compared to standard practices.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 1200 (estimated) |
| Ages | 80 Years and up |
| Sex | All |
| Sponsor | Royal Victoria Hospital, Canada Academic / other |
| Locations | 1 site (Barrie, Ontario) |
| Trial ID | NCT06002113 on ClinicalTrials.gov |
What this trial studies
This study aims to improve end-of-life care for elderly patients by facilitating discussions about their goals of care. It involves hospitalized patients aged 80 and older who will participate in guided conversations regarding their preferences for life-sustaining treatments. The study will compare the outcomes of these facilitated discussions against usual care, focusing on metrics such as ICU days, patient satisfaction, and quality of communication. The goal is to ensure that medical care aligns with patients' values and preferences, ultimately reducing unwanted interventions.
Who should consider this trial
Good fit: Ideal candidates are hospitalized patients aged 80 years and older with acute medical or surgical conditions who can communicate their preferences.
Not a fit: Patients who are clinically unstable or currently receiving acute life support treatments may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could lead to more personalized and compassionate end-of-life care for elderly patients.
How similar studies have performed: While the approach of facilitating goals of care discussions is gaining traction, this specific methodology and tool is novel and has not been extensively tested in similar studies.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Hospitalized patients ≥ 80 years old with an acute medical or surgical condition admitted to any hospital ward * Previously or currently documented CODE STATUS preferences include any life sustaining therapies * Duration of admission ≥ 24 hours * English speaking, or translator present * Competent patient or substitute decision maker Exclusion Criteria: * Treating physician, patient, or substitute decision maker declines * Documented resuscitation preferences for comfort or supportive care * New diagnosis of life-limiting illness on this hospital admission, for example, new diagnosis of metastatic cancer * Clinically unstable, admitted to an intensive care unit, or currently receiving acute life support treatment (mechanical ventilation, acute dialysis, or inotropic/vasopressor support) * Readmission after index hospitalization * Pre-existing need for chronic mechanical ventilation (invasive mechanical ventilation via tracheostomy \> 90 days) or maintenance dialysis (peritoneal or hemodialysis \> 90 days)
Where this trial is running
Barrie, Ontario
- Royal Victoria Regional Health Centre — Barrie, Ontario, Canada (Recruiting)
Study contacts
- Principal investigator: Giulio DiDiodato, MD PhD — Royal Victoria Regional Health Centre
- Study coordinator: Giulio DiDiodato, MD PhD
- Email: didiodatog@rvh.on.ca
- Phone: 7057289090
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.