None listed
Conditions
Brief summary
This study aims to better understand the healthcare needs of people with severe lung disease. In particular we will investigate whether 'advance care planning' (a process of discussion between patients, family/carers and health professionals, about values and goals for treatment) can result in increased patient satisfaction with care and/or a better match between preferred and actual medical treatments.
Interventions
The intervention is a nurse-led advance care planning (ACP) discussion, in collaboration with the primary treating doctor and usual health care team. The nurse will facilitate the doctor and broader health care team to initiate ACP discussions with eligible patients, and will assist in the documentation, distribution and storage of ACP documents for the duration of the trial. They will also be a 'point of contact' for patients who are recruited to trial, and will be available for further discu
The intervention is a nurse-led advance care planning (ACP) discussion, in collaboration with the primary treating doctor and usual health care team. The nurse will facilitate the doctor and broader health care team to initiate ACP discussions with eligible patients, and will assist in the documentation, distribution and storage of ACP documents for the duration of the trial. They will also be a 'point of contact' for patients who are recruited to trial, and will be available for further discussion about advance care planning if necessary. ACP discussions will include the following elements: eliciting patient/carer understanding of current health state, providing information about patient prognosis (if possible and appropriate), eliciting patient/carer perspectives on 'living well', eliciting patient/carer understanding of potential future medical treatments, values and goals of care, cultural/spiritual beliefs, preferences for future medical treatments, understanding of 'medical futility', understanding of 'time limited trials of treatment'. The ACP discussion will also include a discussion about who would be an appropriate person to contact if the patient was unable to communicate. The ACP discussion intervention is provided at least once, and participants will be assured that if they ever wish to revisit this discussion, they can do so by contacting the research nurse and/or usual healthcare provider. ACP discussions will probably take between 30 minutes and 60 minutes, and may occur over multiple consultations. Follow up ACP discussions with the research nurse will be available from the time of recruitment into the study, through until the completion of follow-up (18 months later after commencement of recruitment phase).
Sponsors
Rural Clinical School of WA, University of Western Australia
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
Cognitively competent to provide consent and undertake ACP English speaking Severe respiratory disease Treated at participating healthcare settings Identified as high risk, based on fulfilling one or more general triggers or 'disease specific' triggers
Exclusion criteria
Lack of capacity to provide informed consent or participate in ACP Non-English speaking patient Patient expected to die within 48 hours Formal advance care planning already in place Currently on an end-of-life care pathway
Outcome results
None listed