"Developing and piloting a multi-component technology-based care intervention to address patient symptoms and caregiver burden in home hospice"
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PROJECT SUMMARY Candidate: Dr. Veerawat Phongtankuel is an Assistant Professor at Weill Cornell Medicine with expertise in geriatrics and palliative medicine. His long-term goals are to improve care for older adults and their caregivers (CGs) by reducing suffering, CG burden, and burdensome care transitions at the end of life (EoL) while establishing himself as a leader in the field of geriatrics and palliative medicine. Research: With the growth of hospice, older adults have the opportunity to receive home-based care aimed at reducing suffering and focusing on quality of life at the EoL. However, almost half of all live hospice discharges result in a hospitalization, often leading to unwanted and futile care and increased healthcare costs. Although reasons for hospitalizations are complex, this candidate's research suggests that patient symptoms and CG burden are significant contributors. The current model of home hospice care consisting of nursing visits can be inadequate to address patient symptoms and CG burden that can fluctuate on a daily basis. While use of technology and educational videos has yet to be fully developed, structured, and evaluated in home hospice care, it has shown promise to improve care in other settings. Therefore, this proposal aims to develop and evaluate a multi-component technology-based care intervention, i.e., Improving Home hospice Management of End of life issues through technology (I-HoME), that focuses on assessing and addressing patient symptoms and CG burden in the home hospice setting through synchronous live video visits and educational videos. The aims for the project are, (1) To employ an iterative user-centered design process to develop I-HoME for home hospice patients and their CGs and (2) To conduct a randomized pilot study evaluating the feasibility and potential efficacy of I-HoME (N=50) compared to usual care (N=50). The scientific results obtained will provide the foundation for a R01 application to evaluate the outcomes of I-HoME in a multi-site RCT. Career Development: Dr. Phongtankuel has assembled a preeminent group of interdisciplinary mentors (Drs. Reid, Czaja, and Prigerson) and collaborators with expertise in medicine, nursing, palliative/hospice care, caregiving, user-centered design, computer science, and technology implementation in older adults. His career development plan integrates coursework, seminars, and mentorship in the following areas: (1) Advanced training in symptom management and caregiving, (2) Home hospice care delivery, (3) Skills in intervention development and clinical trials, (4) Mentorship and leadership development, and (5) Grant writing. With from lead suppor Weill Cornell Medicine and the Visiting Nurse Service of New York, Dr. Phongtankuel is well-positioned to palliative care research initiatives in New York. t The proposed training and support will provide Dr. Phongtankuel with the skills and experience to become a transformative leader in developing, implementing, and delivering innovative care models using technology to improve care forpatients and CGs receiving hospicecare at home.
