An interventional study of GOCD Tool and Usual care in Goals of Care, Patient Preference and End of Life, sponsored by Royal Victoria Hospital, Canada. Recruiting at 1 site in Canada. Open to participants aged 80 Years and older. Per ClinicalTrials.gov, last updated 2025-11-21.
Sponsored by Royal Victoria Hospital, Canada · Not applicable, Interventional, and Health services research
Patient-centered medical care considers a patient's values and goals for their health and well-being. Healthcare providers use this information to formulate a medical care plan that is aligned with these expectations. This shared-decision making process should occur with every medical decision, but it is especially important whenever decisions about end-of-life care are being considered. Eliciting patient preferences about resuscitation and life-support treatments in the event of life-threatening illnesses are considered to be a standard of excellent and appropriate medical care. Unfortunately, these discussions don't happen consistently and even when they do occur, are rarely ideal. The consequences can be devastating, often resulting in the delivery of unwanted medical care that can be associated with significant physical and mental suffering among patients and their families. In response to this problem, the investigators developed a novel tool to help guide these difficult conversations between healthcare providers and patients. The investigators previously tested this tool in a small group of hospitalized patients who found it acceptable and helpful. In this larger study, the investigators will compare how effective this tool is compared to usual care in ensuring hospitalized patients have their treatment preferences identified, documented and result in end-of-life care that is consistent with their preferences.
Objectives:
Design:
A prospective, single-centre, stratified, parallel group, allocation concealed, analyst-masked, randomized, pragmatic, mixed-method, comparative effectiveness trial in hospitalized elderly patients 80 years and older.
Participants:
This study will include all elderly patients admitted to the Royal Victoria Regional Health Centre in Barrie, Ontario, Canada, with an acute medical or surgical diagnosis who fulfill all the inclusion criteria and for whom none of the exclusion criteria exist.
112 studies on the registry are indexed under Patient Preference; 28 are open to participants now.
This study's planned enrollment of 1,200 is above the median of 134 across 52 interventional studies indexed under Patient Preference.
Browse Patient Preference studies →Royal Victoria Hospital, Canada is the lead sponsor of 10 studies on the registry; 2 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.
Metastases
Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Intensive care unit-facilitated goals-of-care discussion using web-based shared-decision making software tool
Other: GOCD Tool
Usual discussions conducted by attending physician with patient
Other: Usual care
Web-based tool with 4 components; pre-admission health status; current illness prognosis for hospital survival; in-hospital cardiorespiratory arrest prognosis; values and goals of care
Attending physicians responsible for GOCD during hospitalization using their usual approaches
ICU-related health care utilization
total number of ventilator, ICU, and dialysis days
Time frame: From the time of index hospital admission until hospital discharge or death, up to 12 months after the time of index hospital admission
ICU-related health care utilization
total number of hospital, ventilator, ICU, and dialysis days
Time frame: 12 months after admission from index hospital admission
CODE STATUS resuscitation preferences
Distribution of resuscitation preferences documented in CODE STATUS
Time frame: At the time of index hospital discharge or death during the index hospitalization, up to 12 months after the time of index hospital admission
Change in CODE STATUS preferences
Proportion of patients who change documented CODE STATUS preferences
Time frame: At the time of index hospital discharge or death during the index hospitalization, up to 12 months after the time of index hospital admission
Resuscitation level designation
proportion of patients with completed resuscitation preferences identified
Time frame: At the time of index hospital discharge or death, up to 12 months after the time of index hospital admission
Distribution of ICU-related days of health care utilization
compare empirical distributions of total days of health care utilization
Time frame: From index hospital admission until hospital discharge or death in hospital, assessed up to 12 months
Time required to complete GOCD-facilitated discussion
Total time required to complete intervention
Time frame: From index hospital admission until hospital discharge or death in hospital, assessed up to 12 months
Quality of communication
assessment of patient perceptions of quality of goals of care discussion
Time frame: From index hospital admission until hospital discharge or death in hospital, assessed up to 12 months
patient satisfaction with GOCD discussion
patient satisfaction with goals of care discussions
Time frame: From index hospital admission until hospital discharge or death in hospital, assessed up to 12 months
Evaluation of GOCD tool
patient's perceptions of quality of web-based tool
Time frame: From index hospital admission until hospital discharge or death in hospital, assessed up to 12 months
Patient-provider agreement on resuscitation preferences
decision concordance between patients and providers
Time frame: From index hospital admission until hospital discharge or death in hospital, assessed up to 12 months
Death
date and time and place of death during study period
Time frame: From index hospital admission until hospital discharge or death in hospital, assessed up to 12 months
Direct hospital costs
Difference in direct hospital costs
Time frame: From index hospital admission until hospital discharge or death in hospital, assessed up to 12 months
Plan to share: No — Only upon request, de-identified data may be shared
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Royal Victoria Hospital, Canada