Clinical trial NCT05575791: Evaluation of Preoperative Acceptance of Proactive Palliative Care Intervention
Official title: Evaluation of Preoperative Acceptance of Proactive Palliative Care Intervention
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Cancer
Heart Failure
Chronic Obstructive Pulmonary Disease
Postoperative Complications
Lead sponsor: Charite University, Berlin, Germany
Sponsor class: OTHER
First posted: 2022-10-12
Enrollment: 100
Sex: ALL
Minimum age (years): 19
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The participants will be selected out of the population consulted at the anesthesiology outpatient clinic of the University hospital Berlin - Charite.

Brief summary: Advances in medicine have led to an increased life expectancy even with complex disease courses of malignant diseases.

This leads to frequent critical situations for patients and high risk surgical interventions. The majority of patients and their practitioners are not prepared for the consequences of a complex and possibly fatal course.

Palliative medicine makes it possible to anticipate the further course of the disease. As a result, palliative medicine has become increasingly important. The beginning of palliative medical interventions has extended from accompaniment limited to the dying phase to earlier phases of the disease.

An early integration of palliative medicine showed a positive effect on the quality of life, the degree of depression and survival in patients suffering from cancer, for example. Furthermore, patients were more able to accept a change in therapy goal at the end of life. Similar results were shown for patients with a non-malignant severe disease such as COPD or heart failure.

What needs further investigating is how to adequately screen and identify the patient populations who could benefit from early palliative care, so that they are prepared for potentially critical and life-threatening situations.

The investigator's objective is therefore whether the Anesthesiology Outpatient Clinic is a suitable screening location for initiating early integrated palliative care for patients with a serious, life-shortening illness and a high perioperative risk.


Eligibility criteria: Inclusion Criteria:

* over 18 years
* one elective operation with medium or high cardiac risk

And in addition at least one of the following criteria:

* serious comorbidity pulmonary: Emphysema and / or COPD \>= 2 after GOLD cardiac: NYHA \> = 2
* and / or a metastatic malignancy
* ASA physical status classification \>= 3 and pre-frail or frail

Exclusion Criteria:

* legal care
* Emergency operation
* any reasons which contradict inclusion in studies , e.g. cognitive deficit and lack of language skills
* Pregnant / breastfeeding women

Primary outcomes:
measure: Acceptance of the preoperative palliative counseling offer
timeFrame: through study completion, an average of 1 year
Secondary outcomes:
measure: Advance planning documents
timeFrame: through study completion, an average of 1 year
measure: Postoperative palliative counseling
timeFrame: through study completion, an average of 1 year
measure: Acceptance of the preoperative palliative counseling offer depending on the underlying disease
timeFrame: through study completion, an average of 1 year
measure: Therapy target decision-making situations
timeFrame: through study completion, an average of 1 year
measure: Gender difference
timeFrame: through study completion, an average of 1 year
measure: Therapy goal decisions postoperatively
timeFrame: through study completion, an average of 1 year
Other outcomes:
Locations:
city: Berlin-Steglitz
country: Germany
facility: Department of Anesthesia and operative intensive Care, Campus Benjamin Franklin, Charité - University Hospital Berlin
state: Berlin
Study officials:
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