학술논문
CELPI: trial protocol for a randomised controlled trial of a Carer End of Life Planning Intervention in people dying with dementia.
Document Type
Academic Journal
Author
Arendts G; Discipline of Emergency Medicine, Medical School, University of Western Australia, Perth, WA, Australia. glenn.arendts@uwa.edu.au.; Chenoweth L; Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia.; Hayes BJ; Northern Health Epping, Victoria, Australia.; Campbell E; Geriatric Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.; Agar M; Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology, Sydney, Australia.; Etherton-Beer C; WA Centre for Health and Ageing, University of Western Australia, Perth, WA, Australia.; Spilsbury K; University of Notre Dame, Fremantle, WA, Australia.; Howard K; School of Public Health, University of Sydney, Camperdown, NSW, Australia.; Braitberg G; Emergency Medicine, Austin Health, Victoria, Australia.; Cubitt M; Emergency Medicine, The Royal Melbourne Hospital, Victoria, Australia.; Sheehan C; Palliative Care Medicine, St George Hospital, NSW, Kogarah, Australia.; Magann L; Palliative Care Medicine, St George Hospital, NSW, Kogarah, Australia.; Sudharshan T; Emergency Medicine, Liverpool Hospital, Sydney, Australia.; Schnitker LM; School of Nursing, Queensland University of Technology, Brisbane, Australia.; Pearce J; Fiona Stanley Hospital, Murdoch, WA, Australia.; Gilmore I; Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology, Sydney, Australia.; Cerra N; Northern Health Epping, Victoria, Australia.; duPreez J; Discipline of Emergency Medicine, Medical School, University of Western Australia, Perth, WA, Australia.; Jaworski R; Discipline of Emergency Medicine, Medical School, University of Western Australia, Perth, WA, Australia.; Soh SC; Discipline of Emergency Medicine, Medical School, University of Western Australia, Perth, WA, Australia.; Celenza A; Discipline of Emergency Medicine, Medical School, University of Western Australia, Perth, WA, Australia.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 100968548 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2318 (Electronic) Linking ISSN: 14712318 NLM ISO Abbreviation: BMC Geriatr Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Dementia is a leading cause of death in developed nations. Despite an often distressing and symptom laden end of life, there are systematic barriers to accessing palliative care in older people dying of dementia. Evidence exists that 70% of people living with severe dementia attend an emergency department (ED) in their last year of life. The aim of this trial is to test whether a Carer End of Life Planning Intervention (CELPI), co-designed by consumers, clinicians and content specialists, improves access to end of life care for older people with severe dementia, using an ED visit as a catalyst for recognising unmet needs and specialist palliative care referral where indicated.
Methods: A randomised controlled trial (RCT) enrolling at six EDs across three states in Australia will be conducted, enrolling four hundred and forty dyads comprising a person with severe dementia aged ≥ 65 years, and their primary carer. Participants will be randomly allocated to CELPI or the control group. CELPI incorporates a structured carer needs assessment and referral to specialist palliative care services where indicated by patient symptom burden and needs assessment. The primary outcome measure is death of the person with dementia in the carer-nominated preferred location. Secondary outcomes include carer reported quality of life of the person dying of dementia, hospital bed day occupancy in the last 12 months of life, and carer stress. An economic evaluation from the perspective of a health funder will be conducted.
Discussion: CELPI seeks to support carers and provide optimal end of life care for the person dying of dementia. This trial will provide high level evidence as to the clinical and cost effectiveness of this intervention.
Trial Registration: ACTRN12622000611729 registered 22/04/2022.
(© 2022. The Author(s).)
Methods: A randomised controlled trial (RCT) enrolling at six EDs across three states in Australia will be conducted, enrolling four hundred and forty dyads comprising a person with severe dementia aged ≥ 65 years, and their primary carer. Participants will be randomly allocated to CELPI or the control group. CELPI incorporates a structured carer needs assessment and referral to specialist palliative care services where indicated by patient symptom burden and needs assessment. The primary outcome measure is death of the person with dementia in the carer-nominated preferred location. Secondary outcomes include carer reported quality of life of the person dying of dementia, hospital bed day occupancy in the last 12 months of life, and carer stress. An economic evaluation from the perspective of a health funder will be conducted.
Discussion: CELPI seeks to support carers and provide optimal end of life care for the person dying of dementia. This trial will provide high level evidence as to the clinical and cost effectiveness of this intervention.
Trial Registration: ACTRN12622000611729 registered 22/04/2022.
(© 2022. The Author(s).)