A Multifaceted Intervention Strategy for Relatives of End-of-life Patients in the Emergency Department: a Cluster Randomized Trial

What this Trial Is About

Researchers are investigating whether a multifaceted support program can reduce prolonged grief disorder (PGD) in relatives of patients who die in the emergency department (ED). The study is motivated by evidence that about 0.2% of patients visiting French EDs die there, and that relatives of dying patients often experience intense grief and post-traumatic stress disorder (PTSD). While similar interventions have shown benefits in intensive care units (ICUs), it is unclear if they work in the ED setting where exposure times are shorter and staff are less accustomed to end-of-life care. The study compares usual care to a multifaceted intervention that includes proactive communication, written information about palliative care, and the opportunity for relatives to be present during nursing and medical care. Relatives in the intervention group will have a meeting with healthcare staff, receive brochures, and may have a dedicated interview and psychological follow-up after the patient's death. The study is randomized and open-label, with two groups: usual care and the multifaceted intervention. Participants are relatives of patients expected to die within 72 hours in the ED and must be at least 18 years old, able to understand French, and agree to follow-up phone interviews at 3 and 6 months. Researchers will assess prolonged grief using the PG-R-13 scale at 6 months, and secondary outcomes include PTSD symptoms and anxiety or depression measured at 3 months. The study will monitor participants' psychological status over time, aiming to understand if the intervention lowers grief and stress symptoms after loss.

A Multifaceted Intervention Strategy for Relatives of End-of-life Patients in the Emergency Department