ArticleBMJ open2019
Primary Palliative Care for Emergency Medicine (PRIM-ER): Protocol for a Pragmatic, Cluster-Randomised, Stepped Wedge Design to Test the Effectiveness of Primary Palliative Care Education, Training and Technical Support for Emergency Medicine.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03424109 (Primary Palliative Care for Emergency Medicine), which is not on this map. Cited by 37 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Primary Palliative Care for Emergency Medicine (PRIM-ER)
Who cites it
37 citing papers in PubMed, 58 citations in OpenAlex.
- Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.JAMA · 2025Trial
- Natural Language Processing to Identify Advance Care Planning Documentation in a Multisite Pragmatic Clinical Trial.Journal of pain and symptom management · 2022Trial
- Design and implementation of a clinical decision support tool for primary palliative Care for Emergency Medicine (PRIM-ER).BMC medical informatics and decision making · 2020Trial
- Emergency Departments Leading the Transformation of Alzheimer's and Dementia Care: Emergency Care Redesign.Journal of the American Geriatrics Society · 2026Article
- Emergency Departments Leading the Transformation of Alzheimer's and Dementia Care.Journal of the American Geriatrics Society · 2026Article
- Emergency Department-Initiated Hospice and Palliative Care Consultation Among Older Adults: Protocol for a Systematic Review and Meta-Analysis.JMIR research protocols · 2026Article
- Effect of a multi-component palliative care intervention on goals of care discussions for critical patients in the emergency department.Internal and emergency medicine · 2026Article
- Comparing approaches to code status conversations between Thai and American emergency clinicians: a survey study.Emergency medicine journal : EMJ · 2025Article
- Healthy days at home and prognosis of older adults with cancer and non-cancer serious life-limiting illnesses.BMC geriatrics · 2025Article
- Acute Care Use and Prognosis in Older Adults Presenting to the Emergency Department.Journal of pain and symptom management · 2025Article
- Bayesian Hierarchical Penalized Spline Models for Immediate and Time-Varying Intervention Effects in Stepped Wedge Cluster Randomized Trials.Statistics in medicine · 2025Article
- Is palliative care a utopia for older patients with organ failure, dementia or frailty? A qualitative study through the prism of emergency department admission.BMC health services research · 2024Article
- Emergency Palliative Care: Nongoal Concordant Care and Time-Limited Trials in the Emergency Department.Journal of palliative medicine · 2024Article
- Emergency Nurses' Perceived Barriers and Solutions to Engaging Patients With Life-Limiting Illnesses in Serious Illness Conversations: A United States Multicenter Mixed-Method Analysis.Journal of emergency nursing · 2024Article
- Serious illness communication skills training for emergency physicians and advanced practice providers: a multi-method assessment of the reach and effectiveness of the intervention.BMC palliative care · 2024Observational
- Accuracy of the "Surprise Question" in Predicting Long-Term Mortality Among Older Patients Admitted to the Emergency Department: Comparison Between Emergency Physicians and Nurses in a Multicenter Longitudinal Study.Palliative medicine reports · 2024Article
- The differences in code status conversation approaches reported by emergency medicine and palliative care clinicians: A mixed-method study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Article
- Study protocol for a randomized controlled trial: Integrating the 'Time-limited Trial' in the emergency department.PloS one · 2024Article
- Empower Emergency Physicians to Make Patient-Centered Recommendations Regarding Code Status With Serious Illness Communication Training-Resident-Desired, Standard of Emergency Care in 2023.Annals of emergency medicine · 2023Article
- Emergency Providers' Knowledge and Attitudes Toward Hospice and Palliative Care: A Cross-Sectional Analysis Across 35 Emergency Departments in the United States.Journal of palliative medicine · 2023Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
introductionEmergency departments (ED) care for society's most vulnerable older adults who present with exacerbations of chronic disease at the end of life, yet the clinical paradigm focuses on treatment of acute pathologies. Palliative care interventions in the ED capture high-risk patients at a time of crisis and can dramatically improve patient-centred outcomes. This study aims to implement and evaluate Primary Palliative Care for Emergency Medicine (PRIM-ER) on ED disposition, healthcare utilisation and survival in older adults with serious illness. METHODS AND ANALYSIS: This is the protocol for a pragmatic, cluster-randomised stepped wedge trial to test the effectiveness of PRIM-ER in 35 EDs across the USA. The intervention includes four core components: (1) evidence-based, multidisciplinary primary palliative care education; (2) simulation-based workshops; (3) clinical decision support; and (4) audit and feedback. The study is divided into two phases: a pilot phase, to ensure feasibility in two sites, and an implementation and evaluation phase, where we implement the intervention and test the effectiveness in 33 EDs over 2 years. Using Centers for Medicare and Medicaid Services (CMS) data, we will assess the primary outcomes in approximately 300 000 patients: ED disposition to an acute care setting, healthcare utilisation in the 6 months following the ED visit and survival following the index ED visit. Analysis will also determine the site, provider and patient-level characteristics that are associated with variation in impact of PRIM-ER. ETHICS AND DISSEMINATION: Institutional Review Board approval was obtained at New York University School of Medicine to evaluate the CMS data. Oversight will also be provided by the National Institutes of Health, an Independent Monitoring Committee and a Clinical Informatics Advisory Board. Trial results will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT03424109; Pre-results.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.