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Evaluation of a Comprehensive, Adaptable, Life- Affirming, Longitudinal (CALL) palliative care project
Marla R London1, Sylvia McSkimming, Nicholas Drew
1Center for Outcomes Research and Education, Providence Health System, Portland, Oregon 97213, USA. marla.london@providence.org
Journal of Palliative Medicine
|December 15, 2005
Summary
The Comprehensive, Adaptable, Life-Affirming, Longitudinal (CALL) Care intervention improved pain and symptom management for patients with serious illnesses. This approach effectively individualized care, leading to better patient outcomes and reduced hospitalizations.
Area of Science:
- Palliative Care
- Interdisciplinary Health Interventions
- Patient-Centered Care
Background:
- Patients with life-threatening illnesses often need support before formal hospice or hospital palliative care.
- Existing healthcare often focuses narrowly on diagnosis and treatment, neglecting the holistic impact of illness on patients and families.
Purpose of the Study:
- To evaluate the Comprehensive, Adaptable, Life-Affirming, Longitudinal (CALL) Care intervention.
- To assess CALL Care's effectiveness for patients with cancer, cardiac, respiratory, or dementia diagnoses.
- To ensure alignment with the 2004 Clinical Practice Guidelines for Quality Palliative Care.
Main Methods:
- Prospective observational study conducted across eleven diverse healthcare sites in the United States.
- Enrolled 295 patients and families, with many participating for over 12 months.
- Utilized patient self-reported questionnaires (Modified City of Hope) and family questionnaires to assess physical, psychosocial, emotional, and spiritual status, alongside healthcare utilization data.
Main Results:
- Participants reported enhanced pain and symptom management.
- Low rates of hospitalization (29%) and critical care admission (7%) were observed during enrollment.
- High hospice utilization (48% of decedents) and a tendency towards dying at home (38% of decedents) were noted.
Conclusions:
- The CALL Care intervention is an effective interdisciplinary approach.
- CALL Care successfully individualizes care for individuals facing life-threatening illnesses.
- This model promotes better symptom control and aligns with quality palliative care standards.
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