COPD (Chronic Obstructive Pulmonary Disease)
Conditions
Keywords
COPD, palliative care, cross-sectoral
Brief summary
The aim of this study is to explore the feasibility and potential for a positive impact of a graduated response for advanced COPD with Enhanced Support. The study is a randomized controlled trial of: * systematic needs assessment * advance care planning * crossectoral virtual conferences. Researchers will compare quality of life and healthcare use of the intervention group with a control group that will be assessed for intervention need at the last follow-up.
Detailed description
The current study is a non-blinded randomized controlled pilot trial. The control group will be offered treatment as usual whereas the intervention group will be allocated to the GRACE model of care. In total, 100 patients and their caregivers will be included. The patients are all community dwelling and attached to the Outpatient Respiratory Medicine Clinic at Hvidovre Hospital. The patients will be randomized by block randomization to intervention and control group with a ratio of 1:1. Furthermore, the patients will be stratified according to which municipality they belong to, to ensure we gather feasibility data from two municipalities. The control group will be offered to be assessed for their eligibility for palliative care through the existing visitation conference at the end of the trial period. Endpoints include: Patient-reported (quality of life, anxiety and depression, self-efficacy), caregiver-reported ( caregiver burden, anxiety and depression, well-being) and patient healthcare use.
Interventions
OTHERStepped care
Graduated palliative cross-sectoral care
OTHERUsual Care
Usual care at the outpatient respiratory clinic
Sponsors
Copenhagen University Hospital, Hvidovre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* COPD * Exacerbation within the last year * Living in Høje Taastrup or Copenhagen * Cognitively relevant * ICECAP-SCM at least two scores of: 1. 1, 2 2. 1, 2 3. 1, 2 4. 1, 2 5. 1, 2, 3 6. 1, 2 7. 1, 2
Exclusion criteria
* Dementia * Psychosis * Substance abuse * Hearing or speech impairment * Cancer * Receiving specialized palliative care or other similar interventions * Immediately dying
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| ICECAP-SCM | 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| HADS | 3 | Anxiety and depression |
| GSE | 3 months | General self-efficacy scale |
| Hospital admissions | 3 months | * Proportion of patients with any hospital admission * Mean number of admissions per patient * Bed days |
| Healthcare use, municipality | 3 months | — |
| ICECAP-SCM | 3 months | — |
| Healthcare use, general practice | 3 months | — |
| Survival | 12 months | — |
| SF12 | 3 months | Health-related quality of life |
| Healthcare use, hospital | 3 months | — |
Countries
Denmark
Contacts
Primary ContactIsabella Drachmann, MSc. in Psychology
Backup ContactKirstine Benthien, Ph.d.
Outcome results
None listed