Hospital at Home (HAH) for palliative care: an evaluation

ISRCTN	ISRCTN75865015
DOI	https://doi.org/10.1186/ISRCTN75865015
Protocol serial number	PSI10-19
Sponsor	Record Provided by the NHS R&D 'Time-Limited' National Programme Register - Department of Health (UK)
Funder	NHS Primary and Secondary Care Interface National Research and Development Programme (UK)

Submission date: 23/01/2004
Registration date: 23/01/2004
Last edited: 21/12/2009

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Chris Todd
Scientific

HSRG, General practice and Primary Care Research Unit
Department of Public Health and Primary Care
University of Cambridge
Forvie Site
Robinson Way
Cambridge
CB2 2SR
United Kingdom

Phone	+44 (0)1223 330322

Study information

Primary study design	Interventional
Study design	Randomised controlled trial
Secondary study design	Randomised controlled trial
Scientific title
Study objectives	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(s)	Not provided at time of registration
Health condition(s) or problem(s) studied	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
Primary outcome measure(s)	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)
Key secondary outcome measure(s)	Not provided at time of registration
Completion date	31/12/1999

Eligibility

Participant type(s)	Patient
Age group	Other
Sex	All
Target sample size at registration	229
Key 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.
Key exclusion criteria	Does not match inclusion criteria
Date of first enrolment	01/04/1995
Date of final enrolment	31/12/1999

Locations

Countries of recruitment

United Kingdom
England

Study participating centre

HSRG, General practice and Primary Care Research Unit

Cambridge
CB2 2SR
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
IPD sharing plan

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Results article	results	04/12/1999		Yes	No