Clinical trial NCT05120154: Building CAPACITI for Community-Based Palliative Care
Official title: Improving Palliative Care in the Home and Community: Building CAPACITI (Community Access to Palliative Care Via Interprofessional Primary Care Teams Improvement) Cluster Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Palliative Care
Keywords: Palliative care
CAPACITI
End of life
Primary care
Early identification
Lead sponsor: McMaster University
Sponsor class: OTHER
First posted: 2021-11-15
Enrollment: 566
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The purpose of this cluster randomized controlled trial is to assess the efficacy of a quality improvement intervention called CAPACITI intended to increase competency among primary care teams to deliver early palliative care. CAPACITI is palliative care training and coaching program for primary care teams, comprised of three, two-month (4 session) modules, each addressing a critical component of implementing a palliative care approach into primary care practice.

Detailed description: Improving access to home-based palliative care can improve patient and system outcomes; however, there is a lack of programs to build capacity among primary care teams to deliver this care. To address this gap, the investigators are offering a quality improvement intervention called CAPACITI. CAPACITI is palliative care training and coaching program for primary care teams, comprised of three, two-month (4 session) modules. Each module addresses a critical component of implementing a PC approach into primary care practice: (1) Identify and Assess; (2) Enhance Communication Skills; (3) Enhance Skills for Ongoing Care (including involvement of family and specialists). Over bi-monthly (one hour) sessions, each CAPACITI module uniquely integrates 3 components: clinical education in the form of expert advice and tips; evidence-based tools; and high-facilitation and expert coaching for adaptation to local context. The study will offer the CAPACITI modules to primary care teams across Canada. Teams that register for a module will be randomized to one of two arms: 1) facilitated learning where the module materials are covered in live webinars, and 2) non-facilitated learning where teams have access to all module materials to use a self-directed approach. The online materials for both study arms will be provided on a learning management system. The investigators will examine the difference between the facilitated and nonfacilitated approaches in teams' abilities to provide a palliative care approach in relation to the content of the module. Ultimately this research program will strengthen the primary care system and increase access to home-based palliative care for patients across Canada.

Eligibility criteria: Inclusion Criteria:

* Each team must be comprised of primary care providers, defined as having a minimum of at least 1 of the following: family physician, nurse practitioner, or nurse and practice coordinator (including manager or administrator) that provides primary care. Teams can be a single provider. Teams can also have other team members (e.g. social worker, pharmacist, etc.).
* Each team must be community-based and willing to provide palliative care, defined as managing symptoms, addressing psychosocial needs, educating patients and families, and coordinating care.

Exclusion Criteria:

* Not community-based
* Not willing to provide palliative care
* Outside of Canada

Primary outcomes:
measure: Proportion of case load identified as requiring a palliative care approach
timeFrame: Up to one month post module
measure: End-of-Life Professional Caregiver Survey (EPCS)
timeFrame: Up to one month post module
measure: Assignment Completion & Change Survey
timeFrame: Up to one month post module
Secondary outcomes:
measure: CAPACITI Competencies Survey
timeFrame: Up to one month post module
measure: Assessment of Interprofessional Team Collaboration Scale II (AITCS II)
timeFrame: Up to one month post module
measure: Module Session Evaluation
timeFrame: Up to one month post module
Other outcomes:
Locations:
city: Hamilton
country: Canada
facility: Juravinski Cancer Centre - Hamilton Health Sciences
state: Ontario
Study officials:
affiliation: Department of Oncology, McMaster University and Juravinski Cancer Centre
name: Hsien Seow, PhD
role: PRINCIPAL_INVESTIGATOR
References: