Goals of Care Discussion for Patients With Advanced Lung and Gastrointestinal Cancer in the Emergency Department of a Comprehensive Cancer Center

N/ARecruitingNCT06420206

M.D. Anderson Cancer Center200 enrolled

Overview

To improve quality of life for participants with advanced cancer, support their families, and lower overall cost of care.

Primary Objective: To compare overall percentage of days spent in an acute care setting over the 30-day period from time of the index emergency department (ED), referred to as Acute Cancer Care Center (ACCC), visit for patients who receive the emergency department-based GOC intervention and those who do not. Secondary Objective: To obtain data on rates of admission to the ICU, death in the hospital setting, symptom improvement for participants hospitalized, hospice referral, survival, and 30-day care costs for participants who receive the GOC intervention in the ACCC and those who do not.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

200

Conditions

Lung Cancer Gastrointestinal Cancer

Interventions

Standard of Care (Acute Cancer Care Center)OTHER

In Group 1, participants will receive the usual standard of care by an emergency care physician not trained in palliative care.

Standard of Care (Goals of Care)OTHER

In Group 2, participants will receive standard of care plus palliative care intervention by an emergency care physician trained in palliative care.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Participant is at least 18 years old presenting to the triage area of the MDACC ACCC for treatment 2. Participant has advanced lung or GI cancer. Advanced cancer patient defined as: locally recurrent or metastatic for which there is no curative treatment available. 3. Participant screens positive for at least 2 of 3 triple threat conditions (dyspnea, altered mental status, or poor performance status) 4. Participant has the ability to speak and write in English 5. Participant has the ability to provide consent OR is accompanied by a LAR able to provide consent Exclusion Criteria: 1. Participant is already enrolled in hospice 2. Participant is comatose 3. Participant has severe intellectual disability 4. Participant has a history of dementia documented in the medical records 5. Participant has baseline communication barriers such as aphasia or deafness 6. Participant is new to MDACC, without established oncology care at our institution at time of ACCC arrival 7. Participant is 18 years or older, currently cared for by pediatrics service 8. Pregnant women 9. Prisoners

Locations (1)

MD Anderson Cancer Center

Houston, Texas, United States

RECRUITING

Outcomes

Primary Outcomes

Quality Of Life Questionnaire

Time frame: through study completion; an average of 1 year

Central Contacts

Ahmed Elsayem, MD,MPH

CONTACT

(713) 745-9911 aelsayem@mdanderson.org

Data from ClinicalTrials.gov

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