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Multidisciplinary Intervention In Chronic GVHD

Not Applicable
Active, not recruiting
Conditions
Graft Vs Host Disease
Coping Skills
Quality of Life
Stem Cell Transplant Complications
Interventions
Behavioral: Usual Care
Behavioral: Horizon Program
Registration Number
NCT04479995
Lead Sponsor
Massachusetts General Hospital
Brief Summary

This research is being done to evaluate the feasibility and efficacy of a multidisciplinary, patient-centered intervention, Horizons Program, versus minimally enhanced standard care to improve quality of life, symptom burden and psychological distress of adults who received an allogeneic hematopoietic stem cell transplant and developed graft versus-host disease (GVHD).

Detailed Description

This randomized research study is being conducted to see if the Horizons Program compared to usual care is manageable and effective at improving understanding of chronic GVHD and treatment, coping, and quality of life.

Randomization means that participants will be put into one of two groups by chance:

* Horizons Program

--Individuals who receive the Horizons Program will attend 8 weekly 90-minute group sessions using a secure TeleHealth videoconferencing system

* Usual care --Individuals who receive usual care will also receive an educational booklet.

The research study procedures include:

* screening for eligibility

* a brief test of videoconferencing software

* completion of three study assessments (after signing consent but before randomization and at 8 weeks and 16 weeks after the start of the Horizons Program)

* Individuals who receive usual care will also receive an educational booklet. It is anticipated 80 people will take part in this research study.

The MGH BMT Survivorship Program is supporting this research study by providing funding for this project.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria
  • adult patients (≥ 21 years) who underwent allogeneic HCT
  • have moderate to severe chronic GVHD
  • are currently receiving their care at the MGH Blood and Marrow Transplant Clinic
  • have the ability to participate in an English language group intervention
Exclusion Criteria
  • Patients with comorbid conditions or cognitive impairment that the treating clinician believes prohibits informed consent or participation in the intervention
  • Vulnerable patients, defined here as prisoners and pregnant women, will not be included in the intervention

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Usual CareUsual CareStandard medical visits to address chronic GVHD, with an additional standardized booklet, in electronic or paper format, containing information on the management of chronic GVHD and stem cell transplant survivorship recommendations. Questionnaire assessment at 8 weeks and 16 weeks after Horizons Program group starts
Horizon ProgramHorizon ProgramEight weekly, audio recorded telehealth videoconferencing sessions. Sessions are 90 minutes. Questionnaire assessments at 8 and 16 weeks after end of videoconferencing sessions
Primary Outcome Measures
NameTimeMethod
Rate of retentionBaseline (pre-randomization) to 8 week follow up

Feasibility will be demonstrated if 80% of participants remain in study

Rate of EnrollmentBaseline (pre-randomization) to 8 week follow up

Feasibility will be demonstrated if ≥50% eligible participants enroll

Rate of adherenceBaseline (pre-randomization) to 8 week follow up

Feasibility will be demonstrated if 80% complete ≥4 of 8 sessions

Secondary Outcome Measures
NameTimeMethod
Medical Adherence: Medication Adherence Report Scale (MARS-5)Baseline (pre-randomization) up to 16 week follow up

We will use linear mixed models to investigate longitudinal differences in medical adherence self management between study groups (MARS-5 score range 5-25, with higher scores indicating greater adherence).

Self-Efficacy: Cancer Self-Efficacy Scale (CASE)Baseline (pre-randomization) up to 16 week follow up

We will use linear mixed models to investigate longitudinal differences in cancer self-efficacy between study groups (CASE score range 0-170, with higher scores indicating greater self-efficacy).

Coping Skills: Measure of Current Status (MOCS)Baseline (pre-randomization) up to 16 week follow up

Using to compare Coping Skills self management target between study groups

We will use linear mixed models to investigate longitudinal differences in coping skills between study groups (CASE score range 0-52, with higher scores indicating greater coping skill).

Symptom Burden: Lee Chronic Graft-Versus-Host Disease Symptom Scale (Lee cGVHD)Baseline (pre-randomization) up to 16 week follow up

We will use linear mixed models to investigate longitudinal differences in symptom burden between study groups (Lee cGVHD score range 0-56, with higher scores indicating worse symptom burden).

Quality of life (QOL): Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT)Baseline (pre-randomization) up to 16 week follow up

We will use linear mixed models to investigate longitudinal differences in quality of life between study groups (FACT-BMT score range 0-164, with higher scores indicating better quality of life).

Psychological Distress: Hospital Anxiety and Depression Scale (HADS)Baseline (pre-randomization) up to 16 week follow up

We will use linear mixed models to investigate longitudinal differences in psychological distress between study groups (HADS score range 0-21, with higher scores indicating greater distress).

Social Support: Medical Outcomes Study Social Support Survey (MOS SSS)Baseline (pre-randomization) up to 16 week follow up

We will use linear mixed models to investigate longitudinal differences in social support self management between study groups (MOS SSS score range 0-100, with higher scores indicating greater support).

Trial Locations

Locations (1)

Massachusetts General Hospital Cancer Center

🇺🇸

Boston, Massachusetts, United States

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