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Telehealth for the Self-Management of Dietary Quality of Life in Patients After Stomach Cancer Surgery

Not Applicable
Active, not recruiting
Conditions
Gastric Carcinoma
Gastroesophageal Junction Adenocarcinoma
Interventions
Other: Best Practice
Other: Questionnaire Administration
Other: Telemedicine Visit
Registration Number
NCT05203627
Lead Sponsor
City of Hope Medical Center
Brief Summary

This clinical trial test whether taking part in a diet support intervention will help with patients nutrition and quality of life after surgery for esophagus or stomach cancer. The information learned by doing this research study may help patients get more information and/or support on eating after esophagus and stomach cancer surgery.

Detailed Description

PRIMARY OBJECTIVES:

I. Assess the feasibility, retention, and satisfaction of the Telehealth Intervention for Self-Management of Eating after Gastric Surgery (TIMES) intervention as measured by the percentage of patients who a) agree to participate; b) complete a majority of the intervention (at least 2 sessions); and c) report satisfaction with the intervention (through structured exit interviews).

II. Assess the preliminary efficacy of TIMES for patient reported outcomes for quality of life (QOL), dietary symptoms, and self-management.

III. Assess the preliminary efficacy of TIMES for objective measures of patient nutrition.

OUTLINE: Patients are randomized in to 1 of 2 arms.

ARM I: Patients receive 4 telehealth sessions over 1 hour each over 4 months. Patients also receive an intervention guidebook.

ARM II: Patients receive standard nutritional support.

After completion of study, patients are followed up for 6 months.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
53
Inclusion Criteria
  • The ability to understand English or Spanish.
  • Undergone curative intent surgery for gastric or gastroesophageal (GE) junction cancer.
  • Began oral intake within the past month.
  • Aged 21 years and older.
  • Able to participate in telehealth sessions.
  • This study will be conducted in patients aged 21 years or older who have undergone curative intent surgery for gastric or GE junction cancer.
  • Age criterion for this trial is based on the National Institute of Health (NIH')s age criteria, which defines an adult as individuals aged 21 years and over. There are no restrictions related to performance status or life expectancy.
  • All subjects must have the ability to understand and the willingness to sign a written informed consent.
Exclusion Criteria
  • Subjects, who in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm II (standard nutritional support)Questionnaire AdministrationPatients receive standard nutritional support.
Arm I (telehealth session, guidebook)Telemedicine VisitPatients receive 4 telehealth sessions over 1 hour each over 4 months. Patients also receive an intervention guidebook.
Arm II (standard nutritional support)Best PracticePatients receive standard nutritional support.
Arm I (telehealth session, guidebook)Questionnaire AdministrationPatients receive 4 telehealth sessions over 1 hour each over 4 months. Patients also receive an intervention guidebook.
Primary Outcome Measures
NameTimeMethod
Feasibility of the Telehealth Intervention - Percent CompletionUp to 6 months

Feasibility of the Telehealth Intervention for Self-Management of Eating after Gastric Surgery (TIMES) intervention will be measured by the percentage of patients who completes two sessions.

Patient reported outcomes - General Self-Efficacy ScaleUp to 6 months

A General Self-Efficacy Scale developed by Jerusalem and colleagues contains 10 items that assess perceived confidence in self-management.

Items are rated on a 4-point Likert scale.

Objective measures of patient nutrition - Skeletal mass IndexUp to 6 months

Sarcopenia/skeletal muscle mass will be calculated at baseline and 6 months through CT scans performed as part of routine follow-up for gastroesophageal cancer include cross-sectional images at the level of the third lumbar vertebra (L3). The cross-sectional area of skeletal muscle mass in this region has been found in multiple studies to correlate with total body skeletal muscle mass. Skeletal muscle mass will be quantified using well described techniques applying a predefined Hounsfield unit (HU) threshold of -25 to 150 HU for skeletal muscle mass. Muscle boundaries will be corrected manually when necessary to obtain cross-sectional areas (cm2) for skeletal muscle. Skeletal muscle index (SMI, cm2/m2) is defined as the cross-sectional area of muscle at the L3 level normalized for BMI.

Feasibility of the Telehealth Intervention - Percent ParticipationUp to 6 months

Feasibility of the Telehealth Intervention for Self-Management of Eating after Gastric Surgery (TIMES) intervention will be measured by the percentage of patients who agree to participate.

Retention of the TIMES interventionUp to 6 months

Measured by the percentage of patients who complete a majority of the intervention (at least 2 sessions).

Satisfaction of the TIMES interventionUp to 6 months

Measured by the percentage of patients who report satisfaction with the intervention (through structured exit interviews). Satisfaction and engagement will be assessed through the exit interview via qualitative data, content analysis approach.

Patient reported outcomes - EORTC-Oesophago-Gastric Cancer ModuleUp to 6 months

(EORTC-OG25) will be assessed with a 25-item measure for esophagogastric cancer-specific symptoms and emotional well-being.

Patient reported outcomes - The Post-Gastrectomy Nutrition QuestionnaireUp to 6 months

The Post-Gastrectomy Nutrition Questionnaire is a tool developed by the investigators to assess patient knowledge about diet and nutrition after surgery for GE cancer.

Each item addresses specific content discussed in the telehealth sessions to assess changes in knowledge. Scoring is based on the number of questions answered correctly.

Patient reported outcomes - European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ30):Up to 6 months

EORTC-QLQ30 will be assessed with a 30-item instrument for QOL assessment, with subscales/items for function, global health, general symptoms (fatigue, pain, nausea, and vomiting), and financial toxicity.

Patient reported outcomes - Patient Activation Measure (PAM)Up to 6 months

Patient Activation Measure (PAM) will be assessed by using a Guttman-like scale that reflects a patient's level of engagement and empowerment in their healthcare.

Objective measures of patient nutrition - WeightUp to 6 months

Weight will be recorded at baseline and 6 months to examine the preliminary efficacy of the intervention on objective measures of patient nutrition. Weight will be measured by kg.

Objective measures of patient nutrition - Body Mass Index (BMI)Up to 6 months

Body Mass Index will be calculated and recorded by dividing weight in Kg by height in m\^2 at baseline and 6 months to examine the preliminary efficacy of the intervention on objective measures of patient nutrition.

Objective measures of patient nutrition - Albumin levelsUp to 6 months

Serum albumin levels collected as routine follow-up care will be recorded at baseline and 6 months to examine the preliminary efficacy of the intervention on objective measures of patient nutrition. Albumin level will be measured g/dl.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

City of Hope Comprehensive Cancer Center

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Duarte, California, United States

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