Clinical trial NCT01746446: LifeCourse: A Supportive Care Approach for Patients Late in Life
Official title: LifeCourse: A Supportive Care Approach for Patients Late in Life
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Ongoing or Significant Medical Condition
Lead sponsor: Allina Health System
Sponsor class: OTHER
Collaborators: name: Robina Foundation
First posted: 2012-12-11
Enrollment: 903
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: The purpose of the study is to test a new model of care for patients with an ongoing or significant medical condition.

Detailed description: LifeCourse is a late life care approach that promotes whole person care through a structured approach built upon an expanded set of palliative care domains and chronic illness care practices. It includes a trained lay healthcare worker as the primary contact who follows the patient across care settings and over time. The care guide asks patients and caregivers to articulate individualized goals and take part in decision making, and uses a family-oriented approach to understand needs, leverage strengths, and empower families to effectively support the individual living with serious illness.

Eligibility criteria: Inclusion criteria

* Patient has an Allina Health primary or specialty provider
* Patient's medical chart indicates an on-going or significant medical condition
* LifeCourse will invite vulnerable patients to enroll, including:
* Critically ill patients
* Cognitively impaired patients
* Elderly patients, some of whom may have cognitive impairment and/or be institutionalized

Exclusion Criteria

* Patient resides in a zip code which does not lie partially within a 45 mile radius from the Allina Health Commons in Minneapolis, Minnesota.
* Patient has not visited an Allina facility, affiliate, or community partner within the last year.
* Patient is eligible for hospice.
* Patient is actively dying.
* Patient is abusive or is discharged against medical advice (AMA).

Primary outcomes:
measure: Patient Quality of Life
timeFrame: Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years.
measure: Patient Care Experience
timeFrame: Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years.
measure: Caregiver care experience
timeFrame: Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years.
measure: Caregiver Quality of Life
timeFrame: Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years.
Secondary outcomes:
Other outcomes:
Locations:
city: Minneapolis
country: United States
facility: Augustana Health Care Center
state: Minnesota
city: Minneapolis
country: United States
facility: Abbott Northwestern Hospital
state: Minnesota
city: Minneapolis
country: United States
facility: Walker Methodist Health Center
state: Minnesota
Study officials:
affiliation: Allina Health
name: Eric W Anderson, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Schellinger S, Cain CL, Shibrowski K, Elumba D, Rosenberg E. Building New Teams for Late Life Care: Lessons From LifeCourse. Am J Hosp Palliat Care. 2016 Jul;33(6):561-7. doi: 10.1177/1049909115574692. Epub 2015 Mar 5.
citation: Fernstrom KM, Shippee ND, Jones AL, Britt HR. Development and validation of a new patient experience tool in patients with serious illness. BMC Palliat Care. 2016 Dec 30;15(1):99. doi: 10.1186/s12904-016-0172-x.
citation: Anderson EW, Frazer MS, Schellinger SE. Expanding the Palliative Care Domains to Meet the Needs of a Community-Based Supportive Care Model. Am J Hosp Palliat Care. 2018 Feb;35(2):258-265. doi: 10.1177/1049909117705061. Epub 2017 Apr 20.
citation: Anderson EW, White KM. "It Has Changed My Life": An Exploration of Caregiver Experiences in Serious Illness. Am J Hosp Palliat Care. 2018 Feb;35(2):266-274. doi: 10.1177/1049909117701895. Epub 2017 Apr 16.
citation: Schellinger SE, Anderson EW, Frazer MS, Cain CL. Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious Illness. Am J Hosp Palliat Care. 2018 Jan;35(1):159-165. doi: 10.1177/1049909117699600. Epub 2017 Mar 23.
citation: Shippee ND, Shippee TP, Mobley PD, Fernstrom KM, Britt HR. Effect of a Whole-Person Model of Care on Patient Experience in Patients With Complex Chronic Illness in Late Life. Am J Hosp Palliat Care. 2018 Jan;35(1):104-109. doi: 10.1177/1049909117690710. Epub 2017 Jan 29.
citation: Cain CL, Taborda-Whitt C, Frazer M, Schellinger S, White KM, Kaasovic J, Nelson B, Chant A. A mixed methods study of emotional exhaustion: Energizing and depleting work within an innovative healthcare team. J Interprof Care. 2017 Nov;31(6):714-724. doi: 10.1080/13561820.2017.1356809. Epub 2017 Sep 18.
citation: Anderson EW, White KM. "This Is What Family Does": The Family Experience of Caring for Serious Illness. Am J Hosp Palliat Care. 2018 Feb;35(2):348-354. doi: 10.1177/1049909117709251. Epub 2017 Jun 30.
citation: Britt HR, JaKa MM, Fernstrom KM, Bingham PE, Betzner AE, Taghon JR, Shippee ND, Shippee TP, Schellinger SE, Anderson EW. Quasi-Experimental Evaluation of LifeCourse on Utilization and Patient and Caregiver Quality of Life and Experience. Am J Hosp Palliat Care. 2019 May;36(5):408-416. doi: 10.1177/1049909118817740. Epub 2018 Dec 13.