Clinical trial NCT05640076: Effects of a 24/7 Palliative Care Service Integration in a Metropolitan Area on Non-oncologic Patients
Official title: Effects of a 24/7 Palliative Care Service Integration in a Metropolitan Area on Non-oncologic Patients
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Palliative Medicine
Hospice and Palliative Care Nursing
Palliative Care
Keywords: Medicine, Palliative
Palliative Care
Hospice and Palliative Care Nursing
Lead sponsor: Azienda Usl di Bologna
Sponsor class: OTHER_GOV
Collaborators: name: IRCCS Azienda Ospedaliero-Universitaria di Bologna
First posted: 2022-12-07
Enrollment: 2831
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: The population in the study is composed of the whole population of patients followed by the palliative care metropolitan service of Bologna respecting the Eligibility criteria shown

Brief summary: This retrospective observational pre-post study aims to test the effects of introducing a remote telephonic consultation availability from the Palliative Care Service for a cohort of non-oncologic patients followed by the same service, their relatives, and the Emergency Medical Services (EMS) and family care physicians taking care of them.

The main question\[s\] it aims to answer are:

* Does the introduction of a remote telephonic consultation availability affect the rate of ED access of non-oncologic Palliative-care followed patients during their last 90 days of life?
* Does the introduction of a remote telephonic consultation availability have an effect on the rate of EMS requests for these patients during their last 90 days of life?
* Which are the main topics of the calls to the Palliative Care Service?

Due to the emergence of COVID-19 pandemic during the study period, a parallel cohort of oncologic patients under 24/7 palliative care by the same service during both the observation periods will be used as reference.

Participants will be followed up from the date of taking-over request to the Palliative Care Service to their death or the end of the period of observation if followup began during their last 90 days of life.

Otherwise, for those being already under home palliative care at the 90th day before their death, follow up will begin at that day.

Researchers will compare two time periods to see if the introduction of a remote telephonic consultation availability has an effect on the supra-mentioned aims.


Eligibility criteria: Inclusion Criteria:

* Patients followed by the Metropolitan Palliative Care Service of Bologna
* Residency in Bologna Metropolitan city

Exclusion Criteria:

* Incomplete data
* Residency outside Bologna Metropolitan City

Primary outcomes:
measure: Emergency Department Admission rate of patients followed by the Palliative Care Service
timeFrame: 48 months
Secondary outcomes:
measure: EMS calls rate from patients followed by the Palliative Care Service
timeFrame: 48 months
measure: Main topics of the calls received from the Palliative Care Service after the full implementation of a 24/7 service
timeFrame: 24 months
Other outcomes:
Locations:
city: Bologna
country: Italy
facility: Azienda Unità Sanitaria Locale
city: Bologna
country: Italy
facility: IRCCS - Policlinico Universitario S.Orsola - Malpighi
Study officials:
References:
citation: Burge F, Lawson B, Johnston G. Family physician continuity of care and emergency department use in end-of-life cancer care. Med Care. 2003 Aug;41(8):992-1001. doi: 10.1097/00005650-200308000-00012.
citation: Barbera L, Paszat L, Chartier C. Indicators of poor quality end-of-life cancer care in Ontario. J Palliat Care. 2006 Spring;22(1):12-7.
citation: Gamblin V, Prod'homme C, Lecoeuvre A, Bimbai A-, Luu J, Hazard PA, Da Silva A, Villet S, Le Deley MC, Penel N. Home hospitalization for palliative cancer care: factors associated with unplanned hospital admissions and death in hospital. BMC Palliat Care. 2021 Jan 26;20(1):24. doi: 10.1186/s12904-021-00720-7.
citation: Thomsen JL, Parner ET. Methods for analysing recurrent events in health care data. Examples from admissions in Ebeltoft Health Promotion Project. Fam Pract. 2006 Aug;23(4):407-13. doi: 10.1093/fampra/cml012. Epub 2006 Apr 4.