Study protocol for a randomized controlled trial: Integrating the 'Time-limited Trial' in the emergency department.

Study protocol for a randomized controlled trial: Integrating the 'Time-limited Trial' in the emergency department.

<h4>Introduction</h4>Time-limited trial (TLT) is a structured approach between clinicians and seriously ill patients or their surrogates to discuss patients' values and preferences, prognosis, and shared decision-making to use specific therapies for a prespecified period of time in...

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Main Authors: Tadayuki Hashimoto, Rachel K Putman, Anthony F Massaro, Youkie Shiozawa, Katherine McGough, Kerry K McCabe, Judith A Linden, Wei Wang, Shan W Liu, Maura Kennedy, Thanh H Neville, Jacqueline M Kruser, Rebecca L Sudore, Mara A Schonberg, James A Tulsky, Kei Ouchi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0313858
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Summary:<h4>Introduction</h4>Time-limited trial (TLT) is a structured approach between clinicians and seriously ill patients or their surrogates to discuss patients' values and preferences, prognosis, and shared decision-making to use specific therapies for a prespecified period of time in the face of prognostic uncertainty. Some evidence exists that this approach may lead to more patient-centered care in the intensive care unit; however, it has never been evaluated in the emergency department (ED). The study protocol aims to assess the feasibility and acceptability of TLTs initiated in the ED.<h4>Methods and analysis</h4>We will conduct a parallel group, clinician-level, pilot randomized clinical trial among 40 ED clinicians. We will measure feasibility (e.g., the time it takes to conduct the TLTs by ED clinicians) and clinician and patient-reported acceptability of the TLT, and also track patients' clinical outcomes via medical record review.<h4>Discussion</h4>This study protocol will investigate the potential of TLT initiated in the ED to lead to patient-centered intensive care utilization. By doing so, the study intends to improve palliative care integration for seriously ill older adults in the ED and intensive care unit.<h4>Trial identifier and registry name</h4>ClinicalTrials.gov ID: NCT06378151 https://clinicaltrials.gov/study/NCT06378151; Pre-results; a randomized controlled trial: Time-limited Trials in the Emergency Department.
ISSN:1932-6203

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