e-IMPAQc Implementation and Evaluation of a Mobile Application for the Systematic Assessment of Patient and Caregiver Reported Outcomes in Quebec Across the Cancer Continuum (eIMPAQc)
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 发起方
- 入组人数
- 500
- 试验地点
- 1
- 主要终点
- Patient activation
研究概览
简要总结
Purpose: The Electronic Implementation of Patient and Caregiver Reported Outcomes across cancer centres in Quebec project, or e-IMPAQc, was launched in 2017. e-IMPAQc's goal is to actively engage patients, their caregivers, healthcare professionals (HCPs), managers, policy makers, researchers and IT personnel to co-develop, implement, and evaluate an evidence-informed electronic patient-reported outcomes (e-PRO) screening and management program across Quebec.
Methods: e-IMPAQc built on the Improving Patient Experience and Health Outcomes Collaborative (iPEHOC) project, the first initiative in the province to implement e-PRO screening and was rolled out in three phases. e-IMPAQc has five main components: 1) primary and secondary standardized e-PRO questionnaires and algorithm; 2) summary report for clinicians with alert system; 3) summary report for patients, with tailored notifications regarding symptom severity; 4) self-management fact sheets library; and 5) clinical dashboard. Phase 1 included initiating change management and the co-development of the e-PRO algorithm with patients, their caregivers, HCPs, managers, policy makers, researchers and IT personnel (herein collectively referred as stakeholders) across seven cancer centres. The iPEHOC algorithm was used as a starting point given its successful implementation in one of the participating cancer centres for several years. Phase 1 also included feasibility work to establish a caregiver-reported outcomes (CROs) algorithm as well as the identification and configuration of appropriate electronic platforms on which to house e-IMPAQc. In Phase 2 the focus was on preparing for imminent implementation through workflow mapping and putting in place implementation support (e.g., site coordinators). A pilot of e-IMPAQc (excluding CROs) was also undertaken at one of the participating centres. In Phase 3, e-IMPAQc is being sequentially rolled out to as many cancer centres as possible and then evaluated. Qualitative and quantitative methods are used to document the process of implementation, patient and caregiver, and knowledge transfer (KT) outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Receiving cancer care at designated center
排除标准
- •Unable to speak English or French
- •Unable to use email and internet
研究组 & 干预措施
Pre-implementation
Outcomes collected in patient populations prior to roll-out of the eIMPAQc
Post-implementation
Outcomes collected in patient populations after roll-out of eIMPAQc
干预措施: eIMPAQc (Other)
结局指标
主要结局
Patient activation
时间窗: Baseline, 4 months
13 items Patient Activation Measure provides an overall score
Quality of life
时间窗: Bsaseline,4 months
The EQ-5D-5L is used to measure health related, quality of life. The scale measures quality of life on a 5-component scale including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each level is rated on scale that describes the degree of problems in that area.
Acceptability of using the eIMPAQc ePRO system in cancer care centres
时间窗: Throughout the implementation period, over the course of each participants' 4-6 month follow-up period
Acceptability of the components of the eIMPAQc program will be assessed through a 40 item eIMPAQc acceptability questionnaire
Patient perception of communication with health care team
时间窗: Baseline, 4 months
6 item Clinician-patient communication subscale of the Primary Care Assessment Survey (PCAS), provides an overall score
Survival
时间窗: In the 18 months following consent
Incidence of mortality
Satisfaction
时间窗: 4 months
Measured using the 8 item Client Satisfaction Questionnaire (CSQ-8)
Symptom severity
时间窗: Baseline, 4 months
Symptom severity as measured by the population-specific eIMPAQc symptom screening algorithm, including the Edmonton Symptom Assessment System Revised (ESAS-r) screening measures. Severity is measured on a scale of 0-10.
Feasibility of using the eIMPAQc ePRO system in cancer care centres
时间窗: Throughout the implementation period, over the course of each participants' 4-6 month follow-up period
Feasibility of using the eIMPAQc symptom screening and management program will be measured using the following metrics: * Rates of consent to use eIMPAQc among eligible patients referred/invited to patriciate * Rates of administration and completion of the eIMPAQc ePRO screening processes * Number and timing of withdrawals * Number of eIMPAQc ePRO screenings that generate an alert and/or clinical action Metrics will be combined with qualitative data from semi-structured interviews with participants to provide an overall assessment of feasibility
Emergency room visits
时间窗: In the 18 months following consent
Using hospital administrative data, we will report on the number of individual visits to the emergency room
次要结局
未报告次要终点
研究者
Sylvie Lambert
Principal Scientist
St. Mary's Research Center, Canada