Evaluation of Preoperative Acceptance of Proactive Palliative Care Intervention

Studien-Informationen Einschlusskriterien Studien-Rationale

Rekrutierend

Studienbeginn:
Dezember 2022

Letztes Update:
14.02.2023

Wirkstoff:
-

Indikation (Clinical Trials):
Lung Diseases, Obstructive, Pulmonary Disease, Chronic Obstructive, Postoperative Complications

Geschlecht:
Alle

Altersgruppe:
Erwachsene (18+)

Phase:
-

Sponsor:
Charite University, Berlin, Germany

Collaborator:
-

Studienlocations
(1 von 1)

Department of Anesthesia and operative intensive Care, Campus Benjamin Franklin, Charité - University Hospital Berlin
12203 Berlin-Steglitz
(Berlin)
GermanyRekrutierend» Google-Maps
Ansprechpartner:
Sascha Treskatsch, MD
Phone: 004930-450 551522
E-Mail: sascha.tresktasch@charite.de» Ansprechpartner anzeigen

Studien-Informationen

Brief Summary:

Advances in medicine have led to an increased life expectancy even with complex disease

courses of malignant diseases.

This leads to frequent critical situations for patients and high risk surgical interventions.

The majority of patients and their practitioners are not prepared for the consequences of a

complex and possibly fatal course.

Palliative medicine makes it possible to anticipate the further course of the disease. As a

result, palliative medicine has become increasingly important. The beginning of palliative

medical interventions has extended from accompaniment limited to the dying phase to earlier

phases of the disease.

An early integration of palliative medicine showed a positive effect on the quality of life,

the degree of depression and survival in patients suffering from cancer, for example.

Furthermore, patients were more able to accept a change in therapy goal at the end of life.

Similar results were shown for patients with a non-malignant severe disease such as COPD or

heart failure.

What needs further investigating is how to adequately screen and identify the patient

populations who could benefit from early palliative care, so that they are prepared for

potentially critical and life-threatening situations.

The investigator's objective is therefore whether the Anesthesiology Outpatient Clinic is a

suitable screening location for initiating early integrated palliative care for patients with

a serious, life-shortening illness and a high perioperative risk.

Ein-/Ausschlusskriterien

Inclusion Criteria:

- over 18 years

- one elective operation with medium or high cardiac risk

And in addition at least one of the following criteria:

- serious comorbidity pulmonary: Emphysema and / or COPD >= 2 after GOLD cardiac: NYHA >

= 2

- and / or a metastatic malignancy

- ASA physical status classification >= 3 and pre-frail or frail

Exclusion Criteria:

- legal care

- Emergency operation

- any reasons which contradict inclusion in studies , e.g. cognitive deficit and lack of

language skills

- Pregnant / breastfeeding women

Studien-Rationale

Primary outcome:

1. Acceptance of the preoperative palliative counseling offer (Time Frame - through study completion, an average of 1 year):
Percentage of patients who accept the palliative counseling offer in relation to the total number of patients identified in the screening of the anesthesia outpatient clinic

Secondary outcome:

1. Advance planning documents (Time Frame - through study completion, an average of 1 year):
Percentage of patients who, as a result of the palliative medical consultation offer, create or want to create a living will or power of attorney

2. Postoperative palliative counseling (Time Frame - through study completion, an average of 1 year):
Percentage of patients who would like further palliative medical advice postoperatively

3. Acceptance of the preoperative palliative counseling offer depending on the underlying disease (Time Frame - through study completion, an average of 1 year):
Percentage of patients with and without a malignant disease who accept the counseling offer

4. Therapy target decision-making situations (Time Frame - through study completion, an average of 1 year):
Percentage of patients in whom a decision to limit therapy occurs in the postoperative course

5. Gender difference (Time Frame - through study completion, an average of 1 year):
Percentage of female patients who accept the counseling offer in relation to male patients

6. Therapy goal decisions postoperatively (Time Frame - through study completion, an average of 1 year):
Percentage of patients who do not accept the offer of counseling and who have difficult therapy goal decisions postoperatively

Quelle: ClinicalTrials.gov

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