Patients in the last week of life (cancer, non-malignant disease) Other
Conditions
Interventions
Research sites will be randomised to either “standard intervention A” or “standard intervention B” (see below), and this will become the standard of care at the research site for the duration of this
Sponsors
University of Surrey
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Aged =18 years 2. Estimated prognosis of =1 week 3. Patient unable to maintain sufficient oral fluid intake (i.e. <1l/day).
Exclusion criteria
Exclusion criteria: 1. Patient is dehydrated (patient eligible for inclusion after correction of dehydration) 2. Patient has a relevant Advance Directive to Refuse Treatment (ADRT) 3. Clinical indication for CAH 4. Clinical contraindication to CAH 5. Contraindication to cannulation 6. Total parenteral nutrition/enteral feeding in situ 7. Patient has had delirium in last 24 h 8. Patient has had audible upper airway secretions in last 24 h 9. Patient likely to be transferred elsewhere for end-of-life care
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of patients that develop delirium during the study. The Nursing Delirium Screening Scale (Nu-DESC) will be used to diagnose patients with delirium. | — |
Secondary
| Measure | Time frame |
|---|---|
| Measured throughout the study: 1. The proportion of patients that receive as-required and/or regular medication for delirium (data derived from drug chart). 2. Time to the first dose of medication for delirium (as-required or regular – data derived from drug chart). 3. Modified Richmond Agitation and Sedation Scale (m-RASS) scores during the study (mean score; proportion time with score 0; proportion time with score 0 to -2 – data derived from clinical observation document). 4. The proportion of patients with audible upper airway secretions (“death rattle” – data derived from clinical observation document). 5. The proportion of patients that receive as-required and/or regular medication for audible upper airway secretions (data derived from drug chart). 6. Time to the first dose of medication for audible upper airway secretions (as-required or regular – data derived from drug chart). 7. Proportion patients that experience pain, shortness of breath, and nausea and vomiting (and require medication for these symptoms – data derived from clinical observation document and drug chart). 8. Adverse effects of clinically-assisted hydration (data derived from clinical observation document). 9. Overall survival (data derived from clinical observation document). 10. Health economic analysis (data derived from clinical observation document and drug chart). 11. Carer feedback on end-of-life care and research participation. | — |
Countries
England, Northern Ireland, Scotland, United Kingdom, Wales
Contacts
Public ContactAndrew;Andrew McClave;McClave
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Outcome results
None listed