A feasibility cluster RCT of the AMBER care bundle
Research type
Research Study
Full title
The management of clinical uncertainty in end of life care: a feasibility cluster RCT of the AMBER care bundle.
IRAS ID
212178
Contact name
Catherine Evans
Contact email
Sponsor organisation
King’s College Hospital NHS Foundation
ISRCTN Number
ISRCTN36040085
Duration of Study in the UK
1 years, 2 months, 30 days
Research summary
500,000 people die per year in the UK; half of all deaths occur in hospital. Most people prefer to die at home but this does not happen because there is little discussion between patients, families, and health care professionals about what they want. It is made worse when it is difficult for health care staff to identify patients, whose situation is clinically uncertain, an area of care many professionals do not possess enough knowledge/skills in. Recent reports have highlighted what can go wrong in the presence of clinical uncertainty and at the end of life; it can be devastating for patients and families.
The AMBER care bundle (ACB) has been developed to care better for hospital patients whose situations are clinically uncertain and are at risk of dying in 1–2 months. For these patients, staff develop a plan with patients (where possible) and their family that documents what is important to them. The patient’s status and their wishes are revisited daily. We have conducted a small study to explore the ACB and observed some benefits and areas of concern. Before more hospitals use the ACB it is really important we rigorously study whether the ACB improves care, or not.
We plan to conduct a feasibility study to compare ACB care with the usual care. The feasibly study will help us know if can recruit enough people, that the outcomes we use reflect what patients and families feel are important, and that the study procedures are workable. We will collect information from patients and their families at different time points. Open interviews with patients, caregivers and staff will help us better understand what they value about the ACB and how it works.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
16/LO/2010
Date of REC Opinion
19 Dec 2016
REC opinion
Further Information Favourable Opinion