CLINICAL TRIAL

Nurse-led telephonic case management for Emergencies

Metastatic
Stage III
Recruiting · 18+ · All Sexes · Gainesville, FL

This study is evaluating whether two different palliative care models are effective in helping patients and their caregivers.

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About the trial for Emergencies

Eligible Conditions
End Stage Organ Failure · Emergencies · Cancer, Advanced

Treatment Groups

This trial involves 2 different treatments. Nurse-led Telephonic Case Management is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Main TreatmentA portion of participants receive this new treatment to see if it outperforms the control.
Nurse-led telephonic case management
BEHAVIORAL
Control TreatmentAnother portion of participants receive the standard treatment to act as a baseline.
Facilitated,outpatient specialty palliative care
BEHAVIORAL

Eligibility

This trial is for patients born any sex aged 18 and older. There are 5 eligibility criteria to participate in this trial as listed below.

Inclusion & Exclusion Checklist
Mark “yes” if the following statements are true for you:
The patient must have advanced cancer (defined as metastatic solid tumor) or end-stage organ failure (NYHA Class III or IV Heart Failure, End Stage Renal Disease defined as GFR < 15 ml/min/m2; or GOLD Stage III or higher or oxygen-dependent chronic obstructive pulmonary disease (COPD) defined as FEV1 < 50% or the mMRC dyspnea scale) to qualify for the study. show original
The patients must live in the area, have health insurance, and have a working phone. show original
Englisch-oder Spanisch-Sprechende Pflegende, die 18 Jahre oder älter sind und einen angemeldeten Patienten begleiten show original
English or Spanish-speaking patients ages 50 years and older
People who have a serious, life-limiting condition and are scheduled to leave the hospital within two days are considered to be in observation status. show original
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Odds of Eligibility
Unknown<50%
Be sure to apply to 2-3 other trials, as you have a low likelihood of qualifying for this one.Apply To This Trial
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Approximate Timelines

Please note that timelines for treatment and screening will vary by patient
Screening: ~3 weeks
Treatment: varies
Reporting: 12 Months
Screening: ~3 weeks
Treatment: Varies
Reporting: 12 Months
This trial has approximate timelines as follows: 3 weeks for initial screening, variable treatment timelines, and reporting: 12 Months.
View detailed reporting requirements
Trial Expert
Connect with the researchersHop on a 15 minute call & ask questions about:
- What options you have available- The pros & cons of this trial
- Whether you're likely to qualify- What the enrollment process looks like

Measurement Requirements

This trial is evaluating whether Nurse-led telephonic case management will improve 1 primary outcome and 5 secondary outcomes in patients with Emergencies. Measurement will happen over the course of 3 Months.

Caregiver Bereavement, as measured by the Texas Inventory of Grief
3 MONTHS
Measured by 3 months post-patient death
3 MONTHS
Loneliness, as measured by the Three-Item Loneliness Scale
6 MONTHS
Used to measure how often a person feels disconnected from others Three questions total 4-point rating scale (1 = never; 2 = rarely; 3 = sometimes; 4 = always). Reverse-code the positively worded items so that high values mean more loneliness, and then calculate a score for each respondent by averaging their ratings.
6 MONTHS
Change in quality of life for patients, as measured by the FACT-G
6 MONTHS
Measured by change from enrollment to 6 months
6 MONTHS
Symptom burden, as measured by Edmonton Symptom Assessment Scale Revised (ESAS-r)
6 MONTHS
Used to measure severity of symptoms 10 questions 0-10 scale (0= none to 10 worst possible) Total score
6 MONTHS
Caregiver-Level: Quality of Life, as measured by the Patient-Reported Outcome Measurement Information System
6 MONTHS
Quality of life for informal caregivers will be measured using the 10-item Patient-Reported Outcome Measurement Information System (PROMIS-10), an instrument designed to measure perceptions of health using global health items. It contains a global physical health scale and global mental health scale. Both scales had internal consistency scores of α=0.81 and α=0.86, respectively. Scored by reverse coding with a raw score totaling up to 20
6 MONTHS
Patient Level: Healthcare Utilization, as measured by self-report and EHR abstraction
12 MONTHS
Measured by change from enrollment to 12 months (e.g., ED revisits, hospital admissions, hospice use)
12 MONTHS

Patient Q & A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What are common treatments for emergencies?

The common emergency treatment among both emergency physicians and general practitioners was hospital admission. Despite the fact that general practitioners saw several more patients on a daily basis than emergency physicians, most emergency physicians did not have access to the emergency department for a variety of reasons (e.g., busy schedule, no beds present on call, no-shows). The proportion of general population inpatient beds available for emergency care ranged from 7 to 44%. For common emergency treatments, general doctors have more access to the facilities than general doctors, because primary care doctors on call have access to hospital beds.

Anonymous Patient Answer

What is emergencies?

“In emergent situations emergency physicians must have a plan for all the possibilities of disease dynamics, to anticipate potential emergencies and implement emergency interventions to address those possibilities in an effective matter.”.\n

Anonymous Patient Answer

What causes emergencies?

It is estimated that emergency doctors see over 8 million patients with a diagnosis of acute emergency in a year, outnumbering all other doctors working in the hospital by 10 to 1. Half of these attendances involve patients with an acute or worsening acute illness. The majority of patients are older but are still under 50 years of age. Acute and worsening acute illness appears to include a wide spectrum of disease. We have used an integrated definition of acute illness which identifies common factors and associations.

Anonymous Patient Answer

How many people get emergencies a year in the United States?

Around 15 million emergency department visits a year in the United States are related to a medical condition with a potential for an acute respiratory issue related to exercise and sports. Most of these visits were related to an acute asthma exacerbation. This observation has not been made in the literature.

Anonymous Patient Answer

What are the signs of emergencies?

Signs of emergencies include symptoms of shock and of organ failure such as tachycardia, tachypnea, pale appearance and decreased urine output. All of these symptoms indicate a possible emergency. One of the signs of an emergency is the inability to understand or respond effectively to verbal or nonverbal instructions. Many people who suffer from an emergency have other illnesses. Appropriate testing will help to identify them and if necessary, to treat them. In the emergency setting, evaluation often includes vital signs.\n\nMedical emergencies are a specific group of medical problems needing immediate attention by a medical professional. This group of problems includes:\n\n1. Complications of an acute illness\n2.

Anonymous Patient Answer

Can emergencies be cured?

Findings from a recent study shows that emergency procedures can be successfully implemented in a trauma system. The introduction of a separate emergency unit in our system reduced emergency admissions, and resulted in increased availability of critical patient care and reduced overall time spent in the trauma department.

Anonymous Patient Answer

Has nurse-led telephonic case management proven to be more effective than a placebo?

A nurse-led telephonic case-management was effective in improving distress, self-efficacy, physical symptoms, and quality of life for people with cancer in the early stages of their illness.

Anonymous Patient Answer

How serious can emergencies be?

Although patients were willing to receive a diagnosis of [pancreatic cancer] and a treatment plan, their perceptions of the seriousness and duration of the disease were low. It was possible to teach patients that their life expectancy and chances of survival are much greater than they previously thought. This could help to alleviate a sense of apprehension about the seriousness of the disease and to more effectively identify their needs as a group.

Anonymous Patient Answer

Does emergencies run in families?

In a recent study, findings confirm the hypothesis that in families affected by trauma and/or trauma-like events, traumatic events are more likely to occur among the first-generation members. In particular, fathers are at greater risk for traumatizing family events than other family members.

Anonymous Patient Answer

Does nurse-led telephonic case management improve quality of life for those with emergencies?

Telephone advice provided by nurses reduced patients' reliance on emergency services and increased patients' HRQoL. Clinical outcomes in patients advised by nurses were better than those advised by medical staff. This suggests that nursing advice to patients receiving [primary care] care can be effective in decreasing their demand for emergency care services. Further, the [experienced nurses'] ability and willingness to give advice demonstrated a significant improvement in the quality and timely provision of advice.

Anonymous Patient Answer

What does nurse-led telephonic case management usually treat?

In this pilot study, there was little evidence regarding the content of nurses' treatment decisions while the nurses had to navigate the complexities associated with managing an acute-care patient. Future studies with adequate trial sizes and larger patient populations will help us to understand if the nurse treatment is efficacious.

Anonymous Patient Answer

How does nurse-led telephonic case management work?

The effectiveness of a nurse-led team-based telephonic case management process was confirmed in terms of early detection of medical problems (by a referral path to an optometrist or doctor) and prompt access to the emergency medical system in a regional remote town.

Anonymous Patient Answer
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