Strengthening primary health care teams with palliative care leaders

Effect of palliative care leaders on early identification of patients needing palliative care and resource utilization: a cluster randomized clinical trial

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN92479122

Enrollment

Registered

2017-02-28

Start date

2015-02-01

Completion date

Unknown

Last updated

2018-11-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Palliative care Not Applicable Palliative care

Interventions

Participating health centers are randomised to one of two groups. Randomization and concealment will be centralized, through a single coordinating center, using a computer-generated block randomizatio

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. GPs and nurses 2. Working at primary health care centers located in the South Health District and the East Health District of Majorca

Exclusion criteria

Exclusion criteria: Unwillingness to participate

Design outcomes

Primary

Measure	Time frame
Current primary outcome measure as of 23/10/2018: Early identification (=90 days before death) rate is assessed through electronic record review from patients who died between 18 to 24 months from randomization Previous primary outcome measure: Early identification (90 days before death) rate is assessed through electronic record review from patients who died between 18 to 24 months from randomization	—

Measure

Time frame

Current primary outcome measure as of 23/10/2018: Early identification (=90 days before death) rate is assessed through electronic record review from patients who died between 18 to 24 months from randomization Previous primary outcome measure: Early identification (90 days before death) rate is assessed through electronic record review from patients who died between 18 to 24 months from randomization

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Secondary

Measure	Time frame
Current secondary outcome measures as of 23/10/2018: 1. Case complexity is assessed through electronic record review from patients who died between 18 to 24 months from randomization 2. Number of patients who die at home is assessed by review of the death certificates from patients who died between 18 to 24 months from randomization 3. Total number of hospital admissions during the final month of life is assessed through electronic record review from patients who died between 18 to 24 months from randomization 4. Total number of emergency room admissions during the final month of life is assessed through electronic record review from patients who died between 18 to 24 months from randomization 5. Percentage of patients with any of the following “determinants of aggressive end-of-life care” during the final month of life is assessed through electronic record review from patients who died between 18 to 24 months from randomization 5.1. Two or more admissions to the emergency room 5.2. Two or more admissions to the hospital 5.3. Two or more admissions to the ICU 5.4. More than 14 days in the hospital 6. Cost of resources during the final month of life (including emergency department visits, outpatient office visits, primary health care visits, inpatient hospital stays, and ICU admissions) will be calculated by standard cost-per-unit prices, obtained from the Balearic official regional bulletin from patients who died between 18 to 24 months from randomization Previous secondary outcome measures: 1. Case complexity is assessed through electronic record review from patients who died between 18 to 24 months from randomization 2. Number of patients who die at home is assessed by review of the death certificates from patients who died between 18 to 24 months from randomization 3. Total number of hospital admissions during the final month of life is assessed through electronic record review from patients who died between 18 to 24 months from randomization 4. Total number o	—

Measure

Time frame

Current secondary outcome measures as of 23/10/2018: 1. Case complexity is assessed through electronic record review from patients who died between 18 to 24 months from randomization 2. Number of patients who die at home is assessed by review of the death certificates from patients who died between 18 to 24 months from randomization 3. Total number of hospital admissions during the final month of life is assessed through electronic record review from patients who died between 18 to 24 months from randomization 4. Total number of emergency room admissions during the final month of life is assessed through electronic record review from patients who died between 18 to 24 months from randomization 5. Percentage of patients with any of the following “determinants of aggressive end-of-life care” during the final month of life is assessed through electronic record review from patients who died between 18 to 24 months from randomization 5.1. Two or more admissions to the emergency room 5.2. Two or more admissions to the hospital 5.3. Two or more admissions to the ICU 5.4. More than 14 days in the hospital 6. Cost of resources during the final month of life (including emergency department visits, outpatient office visits, primary health care visits, inpatient hospital stays, and ICU admissions) will be calculated by standard cost-per-unit prices, obtained from the Balearic official regional bulletin from patients who died between 18 to 24 months from randomization Previous secondary outcome measures: 1. Case complexity is assessed through electronic record review from patients who died between 18 to 24 months from randomization 2. Number of patients who die at home is assessed by review of the death certificates from patients who died between 18 to 24 months from randomization 3. Total number of hospital admissions during the final month of life is assessed through electronic record review from patients who died between 18 to 24 months from randomization 4. Total number o

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Countries

Spain

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Mar 9, 2026