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Symptom Management, Quality of Life and Satisfaction With Care for Advanced Stage Cancers - Control Arm

Withdrawn
Conditions
Cancer
Advanced Cancer
Interventions
Other: Standard of care
Registration Number
NCT02261051
Lead Sponsor
Lancaster General Hospital
Brief Summary

Symptom Management, Quality of Life and Satisfaction with Care for Advanced Stage Cancers is the first part of a two part study (The Lancaster Cancer Care Model (LCCM) - Non-Concurrent Control Study). The primary aim of the study is to compare the proportion of advanced cancer patients who have a hospitalization or emergency department visit in the last 6 months of life before and after implementation of a new care model that provides more comprehensive symptom management and supportive care, including earlier referral to palliative care. The secondary comparative aim is to assess measures of quality of life and satisfaction in both groups. This current study is to collect data on the control group only. After system redesign, we will open an intervention arm study to collect data after implementation of the new care model (about 18-24 months from start of control phase).

Detailed Description

Symptom Management, Quality of Life and Satisfaction with Care for Advanced Stage Cancers is the first part of a two part study (The Lancaster Cancer Care Model (LCCM) - Non-Concurrent Control Study) that was submitted to the National Cancer Institute (NCI) for funding. A decision on funding the full study should be forthcoming in the early part of 2015. The primary aim of the study is to compare the proportion of advanced cancer patients who have a hospitalization or emergency department visit in the last 6 months of life before and after implementation of a new care model that provides more comprehensive symptom management and supportive care, including earlier referral to palliative care. The secondary comparative aim is to assess measures of quality of life and satisfaction in both groups. To accomplish the aims of the study by the end of the funding period, we propose to begin data collection in advance of a funding decision. Should the study not receive funding, the data collected will be used to inform decisions regarding other funding applications and/or implementation of program changes at the Ann B. Barshinger Cancer Institute. Data collection does not represent more than minimal risk for the patients enrolled.

This protocol is for the first phase of the study, which is the enrollment and collection of data on the control group, to serve as the baseline for comparison regarding hospitalizations, ED visits, quality of life, and patient and family satisfaction. To achieve sufficient number of subjects and observed deaths in the control group, we are targeting the start of enrollment and data collection in this group during the third quarter of 2014. If the project is funded, the intervention and enrollment in the intervention group are targeted to start in the second quarter of 2016. Background and study aims are presented for the entire project to provide context, but the intent of this application is only for approval of the enrollment and data collection on the control subjects (which contributes to aims 2 and 3 of the larger project). A second protocol would be presented for review and approval at the start of the intervention if the project funding is granted.

In phase one of the project, subjects would be approached and consented at the point of a determination/diagnosis of advanced cancer and followed until the end of life or the start of the intervention period in the 2nd quarter of 2016 (whichever comes first) per protocol.

This current study is to collect data on the control group only. After system redesign, we will open an intervention arm study to collect data after implementation of the new care model (about 18-24 months from start of control phase).

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Newly diagnosed with a solid tumor-type cancer that is considered either advanced and unresectable or metastatic
Exclusion Criteria
  • Non-English speaking
  • Age < 18

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Non-concurrent control groupStandard of careA group of advanced cancer patients who received care at our Center before implementation of the LCCM model. They will receive current standard of care. This current study is to collect data on the control group only. After system redesign, we will open an intervention arm study to collect data after implementation of the new care model (about 18-24 months from start of control phase).
Primary Outcome Measures
NameTimeMethod
Frequency of patients' ED visits and hospitalizationsCollected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months

All cause: ED admission treat and release, ED admission to inpatient visit and direct inpatient admission

Secondary Outcome Measures
NameTimeMethod
Caregiver burdenCollected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months

Assessed with BASC (Brief Assessment Scale for Caregivers) Caregiver Burden

Caregiver satisfactionCollected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months

Assessed with FAMCARE-2 (patient and family satisfaction with care)

Patient satisfactionCollected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months

Assessed with FAMCARE-2 (patient and family satisfaction with care)

Patient quality of lifeCollected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months

Assessed with FACT-G (Functional Assessment of Cancer-General measure)

Patient symptomsCollected at baseline and every outpatient oncology clinic visit from enrollment until death from any cause or assessed up to 18 months

Assessed with the ESAS-R (Edmonton Symptom Assessment System Revised) and ECOG (Eastern Cooperative Oncology Group) performance status

Trial Locations

Locations (1)

Lancaster General Ann B. Barshinger Cancer Institute

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Lancaster, Pennsylvania, United States

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