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Trial registered on ANZCTR
Registration number
ACTRN12624000603516p
Ethics application status
Submitted, not yet approved
Date submitted
26/04/2024
Date registered
9/05/2024
Date last updated
9/05/2024
Date data sharing statement initially provided
9/05/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparing doctor and patient attitudes towards advanced care planning in the Emergency Department
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Scientific title
Comparing doctor and patient attitudes towards advanced care planning in the Emergency Department
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Secondary ID [1]
312038
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none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Advanced care planning in the elderly
333645
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Condition category
Condition code
Emergency medicine
330331
330331
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0
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Other emergency care
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Public Health
330384
330384
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0
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Health service research
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Comparison between Emergency patients over 70 and medical doctors in the Emergency Department. Both groups will be assessed by questionnaire. Patient over the age of 70 in the Emergency Department will be surveyed with a questionnaire regarding demographic information (including the elderly risk assessment), previous knowledge and ownership of an advanced care directive, comfort level discussing it and best person to have this discussion. Medical staff will also be surveyed with a questionnaire detailing previous advanced acre planning discussions and their frequency, previous formal training, comfort level and any perceived barriers to its discussion. Survey for both groups will take approximately 5-10 minutes to complete. Both groups will be assessed at a single time point only, there will be no follow up.
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Intervention code [1]
328487
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Not applicable
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Comparator / control treatment
The medical doctors will be the reference comparator.
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Control group
Active
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Outcomes
Primary outcome [1]
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Patients – willingness/comfort to discuss advanced care planning in the Emergency Department.
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Assessment method [1]
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Our survey was specifically created for this study. To assess the primary outcome, a likert scale will be used.
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Timepoint [1]
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At initial and only contact with survey
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Primary outcome [2]
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Doctors – comfort level in advanced care planning discussions
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Assessment method [2]
338148
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Our survey was specifically created for this study. To assess the primary outcome, a likert scale will be used.
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Timepoint [2]
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Single time point at initial contact
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Secondary outcome [1]
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Patients - best person/professional to discuss advanced care planning.
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Assessment method [1]
434499
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Our survey was specifically created for this study, it is not previously validated. To assess this secondary outcome, categorical data will be collected: family/carer, General Practitioner, Specialist, Emergency doctor.
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Timepoint [1]
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At initial and only contact with the survey.
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Secondary outcome [2]
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Doctors - best person/professional to discuss advanced care planning.
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Assessment method [2]
434500
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Our survey was specifically created for this study, it is not previously validated. To assess this secondary outcome, categorical data will be collected: family/carer, General Practitioner, Specialist, Emergency doctor.
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Timepoint [2]
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At initial and only contact with survey
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Secondary outcome [3]
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Patients - awareness of advanced care planning
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Assessment method [3]
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Our survey was specifically created for this study, it is not previously validated. To assess this secondary outcome, categorical data will be collected: yes/no answers.
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Timepoint [3]
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At initial and only contact
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Secondary outcome [4]
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Patients - number of pre-existing formal advanced care plans
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Assessment method [4]
434701
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Our survey was specifically created for this study, it is not previously validated. To assess this secondary outcome, categorical data will be collected: yes/no answers.
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Timepoint [4]
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At initial and only contact
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Secondary outcome [5]
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Patients - incidence of previous discussion of advanced care planning.
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Assessment method [5]
434702
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Our survey was specifically created for this study, it is not previously validated. To assess this secondary outcome, categorical data will be collected: yes/no answers
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Timepoint [5]
434702
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At initial and only contact
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Secondary outcome [6]
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Doctors - frequency of advanced care planning discussion
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Assessment method [6]
434703
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Our survey was specifically created for this study, it is not previously validated. To assess this secondary outcome, categorical data will be collected: multiple times a shift, once a shift, once a week, once a month, less than once a month
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Timepoint [6]
434703
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At initial and only contact
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Secondary outcome [7]
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Doctors - incidence of previous formal training
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Assessment method [7]
434704
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Our survey was specifically created for this study, it is not previously validated. To assess this secondary outcome, categorical data will be collected: yes/no answers
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Timepoint [7]
434704
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At initial and only contact
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Secondary outcome [8]
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Doctors - barriers to discussion in the Emergency Department
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Assessment method [8]
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Our survey was specifically created for this study, it is not previously validated. To assess this secondary outcome, categorical data will be collected including :
a) Lack of time
b) Competing clinical priorities
c) Patient refusal or discomfort
d) Lack of confidence/experience
e) Language/culture
f) Lack of information of patient prognosis/medical problems/clinical trajectory
g) Lack of appropriate clinical space
h) other, please specify
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Timepoint [8]
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At initial and only contact
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Eligibility
Key inclusion criteria
Patients –
Inclusion - patients over age of 70 presenting to Emergency Department
Doctors –
Inclusion – Doctors working in Royal North Shore Emergency Department
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Patients - Exclusion – medically unstable (as deemed by treating physician), non-English speaking (unless translated by caregiver present), cognitive impairment (unless primary caregiver present and consents to participate in survey)
Doctors - nil
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Study design
Purpose
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Duration
Cross-sectional
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Selection
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Timing
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Statistical methods / analysis
Mann-Whitney U test for differences in ordinal responses for primary outcomes.
Chi-square test (or Fisher’s exact test) to assess differences in proportions for categorical responses (secondary outcomes).
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
13/05/2024
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Actual
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Date of last participant enrolment
Anticipated
15/07/2024
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Actual
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Date of last data collection
Anticipated
15/07/2024
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Royal North Shore Hospital - St Leonards
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Recruitment postcode(s) [1]
42474
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2065 - St Leonards
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Royal North Shore Emergency Department
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Northern Sydney Local Health District
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
318572
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Address [1]
318572
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Country [1]
318572
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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Northern Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [1]
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https://www.nslhd.health.nsw.gov.au/Research/ResearchOffice/Pages/HREC.aspx
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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19/04/2024
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Approval date [1]
315195
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Ethics approval number [1]
315195
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Summary
Brief summary
Advanced care planning is an important aspect of care of the elderly population. The study plans to investigate how comfortable patients and doctors are discussing this in the Emergency Department and to establish patient awareness, pre-existing advanced care directives, who patients and doctors believe to be the best person to discuss this with and identify any barriers towards discussion in the Emergency Department. By identifying these patient and doctor perceptions, we can improve discussion of advanced care planning and overall patient care.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Louise Hochholzer
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Address
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Royal North Shore Emergency Department, Reserve Rd, St Leonards, NSW, 2065
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Country
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Australia
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Phone
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+61423479387
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Louise Hochholzer
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Address
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Royal North Shore Emergency Department, Reserve Rd, St Leonards, NSW, 2065
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Country
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Australia
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Phone
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+61423479387
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Fax
133951
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Email
133951
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[email protected]
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Contact person for scientific queries
Name
133952
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Louise Hochholzer
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Address
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Royal North Shore Emergency Department, Reserve Rd, St Leonards, NSW, 2065
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Country
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Australia
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Phone
133952
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+61423479387
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Fax
133952
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Email
133952
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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