Nurse-led telephonic case management will be compared to specialty outpatient palliative care for improving quality of life in a planned randomized trial of 1350 older adults with advanced illness.

1350 patients aged 50+ years and 675 of their caregivers across nine emergency departments. Patients have advanced cancer (metastatic solid tumour) or end-stage organ failure (NYHA class III or IV heart failure, ESRD with eGFR <15 mL/min/m2, or GOLD stage III, IV or oxygen-dependent COPD), speak English, are scheduled for ED discharge or observation status, reside locally, have a working telephone, and are insured. Excluded: dementia, received hospice care or ≥2 palliative care visits in the last 6 months, or reside in a long-term care facility.

Nurse-led telephonic case management

Specialty outpatient palliative care

Change in patient quality of lifepatient reported