Effects of a Transitional Palliative Care Model on Patients With End-stage Renal Failure (ESRF)

The Hong Kong Polytechnic University

Status: Completed

Conditions: Renal Failure, End-stage; Palliative Care

Treatments: Behavioral: Transitional community based palliative care

Study type: Interventional

Funder types: Other

Identifiers

NCT02139917

23 January 2014

Details and patient eligibility

About

Primary aim:

1. To compare the effects of customary care and an interventional Home-based Palliative Renal Program (HBPRP) for ESRF patients

2. To compare the effects of customary care and Home-based Palliative Program (HBPP) for ESRF patients

   Secondary aim:

3. To explore the lived experiences of patients with ESRF. Hypothesis The transitional renal palliative care model is associated with decreased in unscheduled hospital readmission, reduce length of stay as well as improved quality of life for patients with end-stage renal failure.

Full description

Objectives

Related to the primary aim:

1. Are there differences in healthcare utilization between the ESRF patients in the customary care group and those in the HBPRP group; in the HBPRP group and HBPP group?

2. Are there differences in evaluated health outcomes (functional status, symptom intensity, and satisfaction with care) between the customary care group and the HBPRP group ; in the HBPRP group and HBPP group?

3. Are there differences in perceived health outcomes (quality of life, caregiver burden) between the customary care group and the HBPRP group; in the HBPRP group and HBPP group?

   Related to the secondary aim:

4. How are the lived experiences compared and contrasted between the customary care group and the HBPRP group; in the HBPRP group and HBPP group?

Enrollment: 76 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient with chronic kidney disease and diabetic mellitus with Creatinine ≥350 milli mole (uM) or those without diabetic mellitus with Creatinine ≥450 milli mole (uM) who refused renal replacement therapy (RRT);
• Patient not suitable for long term renal replacement therapy (RRT) after assessment by renal team (e.g. multiple co morbidities, poor functional status and social support)
• Identified as ESRF patient eligible for palliative care without prior renal replacement therapy
• Ability to speak Cantonese
• Living within the hospital service area
• Ability to be contacted by phone

Exclusion criteria

• Discharged to nursing home or other institution
• Inability to communicate
• Cognitive impairment, mini mental stage examination (MMSE) < 20
• Diagnosed with severe psychiatric disorders such as schizophrenia and bipolar disorder

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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76 participants in 2 patient groups

Transitional Palliative Care

Experimental group

Description:

Transitional palliative care include:- * telephone follow up for early identification of signs and symptoms * home visit for spiritual support

Treatment:

Behavioral: Transitional community based palliative care

Customary care

No Intervention group

Description:

Customary care receive care :- * hospital based medical follow up * general nursing assessment and advice