Using a structured DISCUSS protocol to announce withholding or stopping life support to relatives in emergency departments

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

The intervention trains emergency department clinicians to use the DISCUSS protocol when announcing decisions to withhold or withdraw life‑sustaining treatments. Relatives who receive the first announcement in participating EDs are enrolled and complete questionnaires on anxiety, depression, and post‑traumatic stress symptoms, and some take part in semi‑structured interviews. Caregivers on participating wards also receive the training and provide feedback. Outcomes are compared across multiple French hospital sites to measure changes in relatives' stress and experience of the announcement process.

Why it matters

Who can join: the full rules

Inclusion Criteria:

For relatives, will be included in the study:

* Trusted persons, families or relatives present in the emergency departments and to whom the 1st announcement of a decision to limit or stop therapies is made by a physician participating in the study. Several persons can be included for the same patient (maximum 3) in the following order: trusted person \> family \> close relative.
* Age of trusted person, family or close friends over 18 years old.
* Informed consent given and voice rights signed for families accepting the semi-directed interview.

For caregivers, also included in the study will be:

* Caregivers on participating wards.
* Informed consent given and voice rights signed for families accepting the semi-directed interview.

For partner families, will be included in the study:

* Trusted persons, families or relatives present in the emergency department and to whom the 1st announcement of a decision to limit or stop therapy by a physician in a participating emergency department is made.
* Age of trusted person, family or close friends over 18 years old.
* Signed consent for the right to voice recording.

Exclusion Criteria:

For relatives:

* Trusted person, family or close friend whose announcement would have been made entirely by telephone.
* Trusted person, family or close friend unable to understand or write in French.
* Pregnant women, women in labor or nursing mothers.
* Persons deprived of liberty by a judicial or administrative decision.
* Persons under psychiatric care.
* Persons admitted to a health or social institution for purposes other than research.
* Persons of full age who are subjects to a legal protection measure (guardians, curators).
* Persons not affiliated to a social security system or beneficiaries of a similar system.

For caregivers:

\- Persons not affiliated to a social security system or beneficiaries of a similar system.

Where it's running

• CHU Angers
  Angers, France Recruiting
• CH de Bourg-en-Bresse
  Bourg-en-Bresse, France Recruiting
• CHU de Clermont-Ferrand
  Clermont-Ferrand, France Recruiting
• CHU de Grenoble
  Grenoble, France Recruiting
• Groupement hospitalier centre, Hospices Civils de Lyon
  Lyon, France Recruiting
• Groupement hospitalier nord, Hospices Civils de Lyon
  Lyon, France Recruiting

Study contacts

• Study coordinator: Marion MD DOUPLAT
• Email: marion.douplat@chu-lyon.fr
• Phone: 04 78 86 28 54

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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.