Palliative Care Interventions for Outpatients Newly Diagnosed With Lung Cancer: Phase II
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Lung Cancer
- Sponsor
- VA Office of Research and Development
- Enrollment
- 151
- Locations
- 3
- Primary Endpoint
- Change From Baseline in Functional Assessment of Cancer Therapy-Lung Total Outcome Index Score at Final Visit
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The focus of the study is to test a nurse-led telephone-based palliative care intervention on improving the delivery of care for patients with newly diagnosed lung cancer. The study is a three site randomized control trial to determine the efficacy of the intervention on improving patients' quality of life, symptom burden, and satisfaction of care. Additionally, the study will test an innovative care delivery model to improve patients' access to palliative care. The investigators will also determine the effect of the intervention on patient activation to discuss treatment preferences with their clinician and on clinician knowledge of patients' goals of care.
Detailed Description
Patients meeting entry criteria will be randomized to the intervention arm, palliative care plus usual care, or the usual care arm. Patients randomized to the intervention arm will receive usual oncologic care and phone calls from a nurse. Outcome measures will be collected at baseline and at the end of the patients' primary cancer treatment. The study will be performed at the Puget Sound Health Care System, Birmingham VA and Portland VA. The investigators will recruit individuals (n=138) with lung cancer over 2.5 years. The primary objective is to determine the efficacy of the nurse-led telephone-based palliative intervention on improving patients' quality of life, symptom burden, and satisfaction of care. In addition, using validated instruments, the investigators will assess the effect of the intervention on patient activation to discuss treatment preferences with their clinician and on clinician knowledge of patients' goals of care. The results of this study will inform a future effectiveness/implementation study.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients diagnosed at the Puget Sound Health Care System, Birmingham VA, or Portland VA with a primary diagnosis of lung cancer that requires more than surgical resection:
- •diagnosed within 8 weeks of recruitment
- •must have telephone access
- •ability to understand English
- •able to participate in informed consent process
Exclusion Criteria
- •Patients not eligible to participate in the study include those who are inpatients prior to randomization,
- •those who are under the care of palliative care or hospice at the time of randomization
- •those who have severe mental health disorders
- •those who are unable to speak directly with the nurse over the telephone
- •or those that have the inability to provide informed consent
Outcomes
Primary Outcomes
Change From Baseline in Functional Assessment of Cancer Therapy-Lung Total Outcome Index Score at Final Visit
Time Frame: Baseline and 3 Months
Patient Quality of Life including symptoms as measured by the FACT-L (Functional Assessment of Cancer Therapy-Lung Scale). The FACT-L outcome measure reported is the mean change in the TOI subscale (Total Outcome Index) of the instrument, computed as the differences between final and baseline visit scores. The TOI subscale range is 0-84, with a higher score indicating a better quality of life. Among patients with newly diagnosed lung cancer, provision of a telephone-based palliative care intervention will be associated with a change in FACT-L TOI score. The investigators will assess the difference in FACT-L TOI scores between the intervention and control subjects.
Secondary Outcomes
- Change From Baseline in Patient Satisfaction of Care at Final Visit(Baseline and 3 Months)