None listed
Conditions
Brief summary
This project aims to evaluate individual care packages compared with usual care for complex and unstable symptom management and high care needs patients wishing to return home earlier from hospital or Palliative Care units AND for those requiring high level End of Life Care who wish to remain at home. This may include patients who have cancer or non-cancer diagnoses. Care packages at home could include nursing, domestic support, and equipment provision as well as more expeditious access to Specialist Palliative Care multidisciplinary team (MDT) services and General Practitioners. The evaluation project will explore the net incremental effect on patients and caregivers outcomes and associated net incremental costs relative to usual care.
Interventions
The intervention group (PEACH) involves rapidity in response (where services can be put in place within 24 hours), and higher intensity of hands on nursing hours above what is provided in usual care. This may include nursing services (utilising agency nursing staff) overnight and for longer duration including 24 hour nursing for duration of the package (maximum 3 - 5 days). It also coordinates allied health input (occupational therapy, physiotherapy, pastoral care) if equipment or other services
The intervention group (PEACH) involves rapidity in response (where services can be put in place within 24 hours), and higher intensity of hands on nursing hours above what is provided in usual care. This may include nursing services (utilising agency nursing staff) overnight and for longer duration including 24 hour nursing for duration of the package (maximum 3 - 5 days). It also coordinates allied health input (occupational therapy, physiotherapy, pastoral care) if equipment or other services are needed. The intervention will be differ on a case by case basis and is for a maximum of up to 24 hours/ day for 7 days duration. The study duration is 4 weeks which includes a followup phase.
Sponsors
South West Sydney Local Health District
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1.Patient of the Palliative Care Team 2.General Practitioner currently involved in care at home or willing to be involved on discharge from hospital. 3. Patient lives with carer or will have a carer on discharge. 4. Ability to communicate sufficiently in English or have caregiver or family member who can communicate in English and assist them to complete assessments. 5. Informed consent. 6. Age greater than 18. 7. Also must meet one of the following criteria: a. A patient with complex and unstable symptom management and high care needs whose clinician thinks admission/readmission to hospital may be prevented by the package. b. A patient with complex and unstable symptom management and high care needs currently admitted in acute hospital /Palliative care unit who may not be discharged without comprehensive community services. c. A patient wishing to receive end of life care (anticipated to be within 72 hours duration) at home.
Exclusion criteria
not meeting above inclusion criteria no other exclusion criteria
Outcome results
None listed