Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
PSI10-19
Study information
Scientific title
Acronym
Study hypothesis
To evaluate a Hospital at Home (HAH) service for palliative care. Research questions:
1. Compared to standard care
1.1. Was quality of care better under HAH care?
1.2. Were patients more likely to die at home under HAH care?
1.3. Was pattern of other NHS service use different for patients under HAH care?
2. What were health professionals¿ views of HAH?
3. Did the characteristics and care pathways of HAH patients differ from that of other patients?
4. What were the support needs of patients with lung and colorectal cancer who were likely to become eligible for HAH support?
HAH is a service which offers up to 24 hour hands on nursing care in the home, under the medical supervision of the GP, for up to two weeks for adult terminal patients of all diagnoses. It also offers respite care for patients with cancer, MND and AIDS. Factors of interest were place of death, assessment of patient benefits and quality of care under HAH, characteristics and care pathways of patients referred to HAH.
Ethics approval
Not provided at time of registration
Study design
Randomised controlled trial
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Not specified
Trial type
Not Specified
Patient information sheet
Condition
Symptoms and general pathology: Pain
Intervention
1. Individual Randomised Controlled Trial (RCT) of HAH care versus standard care
2. Survey of health professionals¿ views of HAH, based on pilot study semi-structured interviews
3. Record linkage of electronic data from Cancer Registry, primary and secondary care databases to assess:
3.1. Service use under HAH care versus standard care (incorporated into RCT)
3.2. The characteristics and care pathways of patients referred to HAH versus those not referred
4. Prospective, longitudinal study of colorectal and lung cancer patients eligible for HAH care, and their family carers, beginning when patient care switched from curative to palliative according to hospital
Intervention type
Other
Phase
Not Specified
Drug names
Primary outcome measures
1. Randomised controlled trial: place of death, rated symptom severity and adequacy of care, GP visits, care input from NHS primary and secondary care services during the last two weeks of life
2. Survey: ratings of the importance, benefits and disadvantages of HAH
3. Record linkage: demographic and clinical variables (age, sex, socio-economic status, survival, diagnosis, cause of death), service input variables (contact with oncology services, amount and start date of primary and secondary care NHS input in the last year of life)
4. Longitudinal study: prospective and retrospective expressed need and satisfaction with care, activities of daily living, contacts with health professionals, standard measures of health and quality of life (SF-36, EORTC QLQ-C30), and carer strain (CADI)
Secondary outcome measures
Not provided at time of registration
Overall trial start date
01/04/1995
Overall trial end date
31/12/1999
Reason abandoned
Eligibility
Participant inclusion criteria
1. 186 palliative care patients allocated to HAH and 43 palliative control patients. Comparison between HAH and standard care including both primary and secondary NHS input
2. Survey: 78 community nurses, 136 GPs. Assessment of community care only
3. Record linkage: 121 cancer patients referred to HAH, 206 cancer patients not referred to HAH. Both primary and secondary NHS input included
4. Longitudinal study: 54 lung cancer patients, 46 colorectal cancer patients. Both primary and secondary NHS input included.
Participant type
Patient
Age group
Other
Gender
Both
Target number of participants
229
Participant exclusion criteria
Does not match inclusion criteria
Recruitment start date
01/04/1995
Recruitment end date
31/12/1999
Locations
Countries of recruitment
United Kingdom
Trial participating centre
HSRG, General practice and Primary Care Research Unit
Cambridge
CB2 2SR
United Kingdom
Sponsor information
Organisation
Record Provided by the NHS R&D 'Time-Limited' National Programme Register - Department of Health (UK)
Sponsor details
The Department of Health
Richmond House
79 Whitehall
London
SW1A 2NL
United Kingdom
Sponsor type
Government
Website
Funders
Funder type
Government
Funder name
NHS Primary and Secondary Care Interface National Research and Development Programme (UK)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting
Publication summary
1999 results in http://www.ncbi.nlm.nih.gov/pubmed/10582932
Publication citations
-
Results
Grande GE, Todd CJ, Barclay SI, Farquhar MC, Does hospital at home for palliative care facilitate death at home? Randomised controlled trial., BMJ, 1999, 319, 7223, 1472-1475.