Goals of Care Discussion for Patients With Advanced Lung and Gastrointestinal Cancer in the Emergency Department of a Comprehensive Cancer Center
M.D. Anderson Cancer Center
Summary
To improve quality of life for participants with advanced cancer, support their families, and lower overall cost of care.
Description
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.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
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…
Interventions
- OtherStandard of Care (Acute Cancer Care Center)
In Group 1, participants will receive the usual standard of care by an emergency care physician not trained in palliative care.
- OtherStandard of Care (Goals of Care)
In Group 2, participants will receive standard of care plus palliative care intervention by an emergency care physician trained in palliative care.
Location
- MD Anderson Cancer CenterHouston, Texas