Improving advance care planning for elderly patients at home

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This study aims to develop and evaluate an intervention to enhance advance care planning (ACP) for severely ill elderly patients who are living at home and are acutely admitted to hospitals. It employs a cluster randomized design involving twelve Norwegian acute geriatric hospital units, where half will receive immediate implementation support and training while the other half will receive it after the intervention period. The study will assess implementation outcomes, health service and clinical outcomes through questionnaires and qualitative interviews with staff, patients, and their relatives. The goal is to improve user involvement and quality of life for these patients and their families.

Why it matters

Who can join: the full rules

Inclusion and exclusion criteria for patients and relatives the quantitative and triadic sub-study:

Inclusion criteria for patients:

* Home-dwelling
* 70 years or older
* Acutely admitted to the participating unit
* Sufficient language proficiency in Norwegian to answer the questionnaire
* Clinical frailty score of 4 or more
* The physician responsible for the patient's medical care answers "no" to "Surprise question" from Gold Standards Framework proactive identification guidance
* Both patient and a close relative (preferably the closest relative) would participate in ACP together if offered
* Both patient and the close relative consent to participate in the research project

Exclusion criteria for patients:

* The patient is not competent to consent to research participation
* The patient is expected to die within 24 hours
* The patient has participated in ACP prior to the current hospital admission
* In the intervention arm

  * ACP is not conducted with patient, next of kin and physician before hospital discharge
  * The clinician that participated in the ACP conversation has not consented to research participation
* In the control arm

  * The patient would not have been able to participate in ACP during hospitalization
  * An attending clinician has not consented to research participation

Inclusion criteria for relatives:

* A close relative of a patient who fulfill all inclusion criteria and no exclusion criteria; and who would be willing to participate in ACP together with the patient if offered
* 18 years or older
* Sufficient language proficiency in Norwegian to answer the questionnaire
* Both patient and the close relative consent to participate in the research project

Exclusion criteria for relatives:

* The relative is not competent to consent to research participation
* In the intervention arm

  * ACP is not carried out with the patient, next of kin and attending clinician before hospital discharge
* In the control arm

  * The relative would not have been able to participate in ACP during hospitalization

Where it's running

• Vestre Viken Hospital Trust, Bærum
  Oslo, Bærum kommune, Norway Recruiting
• Hospital of Southern Norway, Arendal
  Arendal, Norway Recruiting
• Vestre Viken Hospital Trust, Drammen
  Drammen, Norway Recruiting
• Innlandet Hospital Trust, Elverum
  Elverum, Norway Recruiting
• Innlandet Hospital Trust, Gjøvik
  Gjøvik, Norway Recruiting
• Vestre Viken Hospital Trust, Kongsberg
  Kongsberg, Norway Recruiting

Study contacts

• Principal investigator: Reidar Pedersen, PhD — Professor, Centre for medical ethics, University of Oslo
• Study coordinator: Reidar Pedersen, PhD
• Email: reidar.pedersen@medisin.uio.no
• Phone: +47 41575987

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.