The ACTIVE Intervention to Improve Hospice Care

Study Overview
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Brief Summary
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The ACTIVE Intervention to Improve Hospice Caregiver Pain Management The major goal of this project is to implement and test this promising intervention in three hospice programs. The mixed methods evaluation of this randomized controlled trial (RCT) will provide evidence-based data for a tested intervention manual that hospice staff members can use to integrate the intervention into their practices.

Detailed Description
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The ACTIVE Intervention to Improve Hospice Caregiver Pain Management The major goal of this project is to implement and test this promising intervention in three hospice programs. The mixed methods evaluation of this RCT will provide evidence-based data for a tested intervention manual that hospice staff members can use to integrate the intervention into their practices. We will rigorously test the effectiveness of the ACTIVE intervention. We will investigate whether the assessment of the informal caregivers perception of pain management will identify those who will benefit most and whether changes in the perceptions of informal caregivers will result in improvement of patient pain. We will explore barriers and challenges in the implementation of this into every day practice within hospice

Official Title
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The ACTIVE Intervention to Improve Hospice Care

Conditions
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Pain

Intervention / Treatment
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* Behavioral: ACTIVE


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Informal Caregiver Inclusion Criteria Informal caregiver of an enrolled hospice patient Age 18 or over and legally able to provide informed consent Involved in decisions related to pain medications Access to at least one of the below: A standard land line telephone A high-speed Internet connection with operational computer Without functional hearing loss or with a hearing aid that allows the participant to conduct phone or Internet conversations as assessed by the research staff (by questioning and observation - Exclusion Criteria:Informal caregivers of hospice patients with a life expectancy less than 14 days as assessed by the hospice nurse with the palliative performance scale (PPS) (99) -
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual Care<br>Usual hospice care- there is no intervention in this arm | |
| Experimental: ACTIVE<br>Behavioral intervention using web conferencing | Behavioral: ACTIVE<br>* Assessing Caregivers for Team Intervention via Video Encounters: this intervention uses video technology to bridge geographic distance to empower hospice caregivers to participate in plan of care meetings for their patient<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Caregiver Perceptions of Pain Medicine Questionaire | This 16 question instrument measures the perceptions hospice caregivers have toward the administration of pain medications. Scores on items vary from 1-5 with the lower scores indicating more problematic perceptions of pain management. A Total score is computed between 16-80 Only the last available measure will be used to reflect the measure closest to time of death. | Every 14 days until the death of the patient for an average of 45 days-Only measure used in analysis is the last completed measure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Caregiver Quality of Life-Revised Subscale Emotional | This is one domain of a four domain instrument. It involves one question with a range of 0-10.Only the last available measure will be used to reflect the measure closest to time of death. | Every 14 days until the death of the patient for an average of 45 days-Only measure used in analysis is the last completed measure | 
| Anxiety | This measure determines the level of anxiety experienced by a hospice caregiver. Total scores range from 0-21 with higher scores representing more anxiety. Only the last available measure will be used to reflect the measure closest to time of death. | Every 14 days until the death of the patient for an average of 45 days-Only measure used in analysis is the last completed measure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hospice, Caregivers, Interdisciplinary Team, Pain management