Background: Many persons with life-threatening illnesses require services before they begin
receiving hospice or hospital-based palliative care. Although health care professionals focus
on diagnosis, treatment, and comfort care, patients and families view the illness as it impacts
their whole life.
Objective: Evaluating a Comprehensive, Adaptable, Life-Affirming, Longitudinal (CALL)
intervention to patients with life-threatening cancer, cardiac illness, respiratory conditions or
dementia. The CALL Care interventions are consistent with the 2004 Clinical Practice Guidelines
for Quality Palliative Care.
Design: Prospective observational study.
Setting and subjects: Eleven sites (1 primary care, 8 acute care, and 2 long term care) located
around the United States. Two hundred ninety-five patients and families enrolled in the study;
many were enrolled for over 12 months.
Measurements: Patient self-reported Modified City of Hope Questionnaire addressing physical,
psychosocial, emotional, and spiritual status and health care experiences; completed at
enrollment and every three months. Family members completed Modified City of Hope Bereaved
Family Questionnaire, with contents similar to the patient questionnaire. Sites compiled
health care and community services utilization data regularly.
Results: Participants reported improved pain and symptom management. Fewer than one
third were hospitalized (29%), and 7% had a critical care admission while enrolled. In addition,
participants had high use of hospice (48% of those who died), and were likely to die at
home (38% of those who died).
Conclusions: CALL Care is an effective interdisciplinary intervention approach to individualize
care for people living with life-threatening illness.
