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Results of the promoting effective advance care planning for elders (PEACE) randomized pilot study.
Popul Health Manag ; 17(2): 106-11, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24156664
ABSTRACT
The specific aim of the PEACE pilot study was to determine the feasibility of a fully powered study to test the effectiveness of an in-home geriatrics/palliative care interdisciplinary care management intervention for improving measures of utilization, quality of care, and quality of life in enrollees of Ohio's community-based long-term care Medicaid waiver program, PASSPORT. This was a randomized pilot study (n=40 intervention [IG], n=40 usual care) involving new enrollees into PASSPORT who were >60 years old. This was an in-home interdisciplinary chronic illness care management intervention by PASSPORT care managers collaborating with a hospital-based geriatrics/palliative care specialist team and the consumer's primary care physician. This pilot was not powered to test hypotheses; instead, it was hypothesis generating. Primary outcomes measured symptom control, mood, decision making, spirituality, and quality of life. Little difference was seen in primary outcomes; however, utilization favored the IG. At 12 months, the IG had fewer hospital visits (50% vs. 55%, P=0.65) and fewer nursing facility admissions (22.5% vs. 32.5%, P=0.32). Using hospital-based specialists interfacing with a community agency to provide a team-based approach to care of consumers with chronic illnesses was found to be feasible. Lack of change in symptom control or quality of life outcome measures may be related to the tools used, as these were validated in populations closer to the end of life. Data from this pilot study will be used to calculate the sample size needed for a fully powered trial.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Calidad de Vida / Cuidados a Largo Plazo / Planificación Anticipada de Atención / Servicios de Atención de Salud a Domicilio Tipo de estudio: Evaluation_studies / Primary_study Límite: Anciano / Femenino / Humanos / Masculino País/Región como asunto: America del Norte Idioma: Inglés Revista: Popul Health Manag Asunto de la revista: Salud Pública / Servicios de Salud Año: 2014 Tipo del documento: Artículo