Special Issue in Honor of J. Randall Curtis, MD, MPHProPACC: Protocol for a Trial of Integrated Specialty Palliative Care for Critically Ill Older Adults
Section snippets
Key Message
This article describes the protocol for a multicenter patient-randomized efficacy trial of integrated specialty palliative care (SPC) versus usual care for older critically ill patients and their surrogate decision-makers. This trial will provide robust evidence about the impact of integrating SPC with critical care on patient, family, and health system outcomes.
Trial Design
This study is a multicenter efficacy trial comparing integrated specialty palliative care (SPC) and critical care to usual care for older ICU patients at high risk of death or severe functional impairment. This trial is NIA funded (R01AG068567), approved by the University of Pittsburgh Institutional Review Board (STUDY20030163) and registered on ClinicalTrials.gov (NCT04921631).
Study Setting
We will conduct this study in six ICUs within five hospitals in the UPMC health system in Pittsburgh, Pennsylvania.
Discussion
This trial would not have been possible without the decades of work by Professor Curtis to change the shape of the field and attitudes towards palliative care in ICUs. Professor Curtis et al. have described many of the key challenges associated with attempts to improve palliative care provision in the ICU.37,70,71 Here, we will discuss three relevant issues we faced in the design of this trial: 1) identification of ICU patients most likely to benefit from SPC involvement; 2) effective
Conclusion
Here, we have described the protocol for a trial of early integrated specialty palliative care for high-risk critically ill patients. We are honored to build on and continue the decades-long effort by Professor Curtis to improve the care of critically ill patients and their families. We are indebted to Professor Curtis, not only for his many contributions to the field, but also for his mentorship and friendship.
Conflicts of Interests
See relevant ICMJE forms.
Disclosure and Acknowledgments
This project is funded by a grant from the National Institute on Aging (R01AG068567). Dr. White and Dr. Schenker both received additional funding from the National Institutes of Health (K24HL148314 and K24AG070285). Sarah K. Andersen is supported by a T32 grant from the National Institutes of Health (T32HL007820).
NIH Clinical Trial Registration
NCT04921631
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