A Pragmatic Trial of an Active Choice Nudge for Generalist or Specialist Palliative Care for Seriously Ill Inpatients

Last updated: April 10, 2026
Sponsor: University of Pennsylvania
Overall Status: Active - Not Recruiting

Phase

N/A

Condition

Cancer

Cancer Treatment

Treatment

Generalist + Specialist palliative care

Pre-Intervention phase

Clinical Study ID

NCT05502861
848497
R01AG073384
  • Ages > 18
  • All Genders

Study Summary

This stepped-wedge, cluster-randomized pragmatic trial among six hospitals at University of Pennsylvania Health System will test a behavioral intervention embedded within the electronic health record that nudges hospital clinicians to either provide palliative care (PC) themselves (generalist PC) or consult specialists (specialty PC) for inpatients at high risk of death within 6 months. The trial will evaluate the intervention's effect compared to usual care on the primary outcome of hospital-free days through 6 months, and other patient-centered, clinical, and economic outcomes. The trial also includes an embedded mixed methods study to understand clinician and hospital contextual factors that influence the intervention's uptake.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Age 18 or older

  • Inpatient or observation admission status at a study hospital

  • Predicted 6-month mortality risk moderate (e.g., ≥40%) or higher

Exclusion

Exclusion Criteria:

  • Under 18 years of age

  • Inpatient primary service: hospice, rehabilitation, obstetrics, psychiatry

  • Patients that have died or been discharged before 0800 on hospital day 3 when themortality risk is generated and enrollment occurs

Study Design

Total Participants: 18884
Treatment Group(s): 2
Primary Treatment: Generalist + Specialist palliative care
Phase:
Study Start date:
November 13, 2023
Estimated Completion Date:
May 17, 2026

Connect with a study center

  • University of Pennsylvania

    Philadelphia, Pennsylvania 19104
    United States

    Site Not Available

  • University of Pennsylvania

    Philadelphia 4560349, Pennsylvania 6254927 19104
    United States

    Site Not Available

Map preview placeholder

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.