The Promoting Effective Advance Care for Elders (PEACE) Randomized Pilot Study: Theoretical Framework and Study Design.

The Promoting Effective Advance Care for Elders (PEACE) Randomized Pilot Study: Theoretical Framework and Study Design.

Allen Kyle R; Hazelett Susan E; Radwany Steven; Ertle Denise; Fosnight Susan M; Moore Pamela S

Population Health Management

2012

2012-04

Practice guidelines are available for hospice and palliative medicine specialists and geriatricians. However, these guidelines do not adequately address the needs of patients who straddle the 2 specialties: homebound chronically ill patients. The purpose of this article is to describe the theoretical basis for the Promoting Effective Advance Care for Elders (PEACE) randomized pilot study. PEACE is an ongoing 2-group randomized pilot study ( n = 80) to test an in-home interdisciplinary care management intervention that combines palliative care approaches to symptom management, psychosocial and emotional support, and advance care planning with geriatric medicine approaches to optimizing function and addressing polypharmacy. The population comprises new enrollees into PASSPORT, Ohio's community-based, long-term care Medicaid waiver program. All PASSPORT enrollees have geriatric/palliative care crossover needs because they are nursing home eligible. The intervention is based on Wagner's Chronic Care Model and includes comprehensive interdisciplinary care management for these low-income frail elders with chronic illnesses, uses evidence-based protocols, emphasizes patient activation, and integrates with community-based long-term care and other community agencies. Our model, with its standardized, evidence-based medical and psychosocial intervention protocols, will transport easily to other sites that are interested in optimizing outcomes for community-based, chronically ill older adults. ( Population Health Management 2012;15:71-77)

Ohio; Aged; Quality of Life; Health Care Costs; Pilot Studies; Practice Guidelines; Study Design; Conceptual Framework; Collaboration; Palliative Care; Depression; Goal-Setting; Disease Management; Multidisciplinary Care Team; Anxiety; Home Health Care; Chronic Disease – In Old Age – Ohio; Health Promotion – In Old Age – Ohio

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

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