Ongoing or Significant Medical Condition
Conditions
Brief summary
The purpose of the study is to test a new model of care for patients with an ongoing or significant medical condition.
Detailed description
LifeCourse is a late life care approach that promotes whole person care through a structured approach built upon an expanded set of palliative care domains and chronic illness care practices. It includes a trained lay healthcare worker as the primary contact who follows the patient across care settings and over time. The care guide asks patients and caregivers to articulate individualized goals and take part in decision making, and uses a family-oriented approach to understand needs, leverage strengths, and empower families to effectively support the individual living with serious illness.
Interventions
OTHERCare team
Provides additional support to patients, family, and friends.
Sponsors
Robina Foundation
Allina Health System
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient has an Allina Health primary or specialty provider * Patient's medical chart indicates an on-going or significant medical condition * LifeCourse will invite vulnerable patients to enroll, including: * Critically ill patients * Cognitively impaired patients * Elderly patients, some of whom may have cognitive impairment and/or be institutionalized
Exclusion criteria
* Patient resides in a zip code which does not lie partially within a 45 mile radius from the Allina Health Commons in Minneapolis, Minnesota. * Patient has not visited an Allina facility, affiliate, or community partner within the last year. * Patient is eligible for hospice. * Patient is actively dying. * Patient is abusive or is discharged against medical advice (AMA).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Quality of Life | Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years. | Patient QOL was measured using the Functional Assessment of Chronic Illness Therapy-Palliative v4 (FACIT-Pal) survey, a general measure of health-related QOL in 4 domains: physical, social, emotional, and functional, plus a measure of end-of-life experiences. Items were reverse scored according to scoring guidelines and domain scores were calculated via prorated scores when there were \<50% missing items for a given domain and \<20% missing domains for a total score. |
| Patient Care Experience | Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years. | Patient care experience was collected via a previously validated survey tool focused on the patient's experience with their care team in the last 30 days. Three domains were scored: care team, goals, and communication with prorated scores when there were \<50% missing items for a given domain and \<20% missing domains for a total score. |
| Caregiver care experience | Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years. | Caregiver care experience was measured by a developed tool, addressing various aspects of care experience. An overall score was calculated by summing answers to all items. Scores were also calculated in 3 domains: care team, communication, and support. |
| Caregiver Quality of Life | Change from baseline survey responses at 3 month intervals until subject withdrawal or date of death from any cause, whichever comes first, up to six years. | aregiver QOL was assessed via the patient-reported outcomes measurement information system (PROMIS) which asks caregivers to report their QOL in 8 domains. The PROMIS-29 scores were calculated by summing answers to all items within each domain. |
Countries
United States
Outcome results
None listed