Summary

The purpose of this project is to discover what interventions in hospice care are associated with the best pain control, dyspnea control, and self-determined life closure, controlling for initial patient differences.  The 2-year project involves 1,800 patients from 15 hospices throughout the US.  ISIS is conducting this Clinical Practice Improvement project of hospice care with the National Hospice and Palliative Care Organization; funding is from the Robert Wood Johnson Foundation.

Primary Objectives

1. Improve outcomes of pain control, dyspnea control, and self-determined life closure in hospice patients.
   

2. Create research-based optimal treatment protocols for hospice patients to improve outcomes of pain, dyspnea, and self-determined life closure.

METHODS

Detailed patient, treatment, and outcome data are being collected on 1,800 hospice patients between April 1, 2001, and March 31, 2003, from 15 hospices throughout the US (120 per hospice).  Study hospices use various methods to control pain and dyspnea, various types and frequency of service personnel to care for patients, and various psychosocial and spiritual interventions.  We will analyze the data to determine care modalities and management strategies that are associated with better pain control, dyspnea control, and self-determined life closure.  Multivariate analyses will control for amount of time in hospice care, underlying disease, severity of illness, and other patient and family factors.