Emergency Department Attendance by Patients with Advanced Cancer (v1)
Research type
Research Study
Full title
How do patients with advanced cancer decide to attend the emergency department, and what influences their decision-making at this time? A qualitative case study
IRAS ID
157391
Contact name
Barbara A Daveson
Contact email
Sponsor organisation
King's College London
Research summary
Background
Many people living with advanced cancer visit the emergency department near the end of life. Often these visits are associated with poor outcomes such as prolonged pain and overall dissatisfaction. However, despite these negative outcomes emergency department visits by advanced cancer patients are increasing. Most of the literature investigating this topic has focused on quantifying emergency department attendance and describing variations in emergency department use according to different patient and environmental factors. Much less is known about why patients attend the emergency department and what factors influence their decision at this time.Aim
To investigate the processes by which advanced cancer patients and their caregivers decide to attend the emergency department, and to explore advanced cancer patients’ and their caregivers’ preferences for an urgent care service.Objectives:
1. To explore how demographic, clinical and environmental factors influence advanced cancer patients’ and their caregivers’ decision to attend the emergency department.
2. To describe the relationship between demographic, clinical, environmental, and any other factor(s) identified.
3. To explore what alternatives were considered by advanced cancer patients and their caregivers when deciding to attend the emergency department.
4. To describe and explore advanced cancer patients’ and their caregivers’ preferences for an urgent care service.Design
Based at King’s College Hospital, this qualitative case-based study will involve interviews with patients and their caregivers, and review of patients’ healthcare records. Interviews will take approximately one hour during which participants will be asked about a recent decision to attend the emergency department and the factors that influenced this decision.Outcome
Study findings will improve our understanding of the needs and preferences of advanced cancer patients requiring urgent care, and assist in the development of a community screeing tool that can help healthcare professionals identify patients at high-risk of overly aggressive end of life care, such as multiple emergency department visits.REC name
South Central - Berkshire Research Ethics Committee
REC reference
14/SC/1207
Date of REC Opinion
1 Sep 2014
REC opinion
Favourable Opinion