Adapting the Tumor Board Model for Mental Illness and Cancer
- Conditions
- Lung CancerBreast CancerGenitourinary CancerSevere Major DepressionSchizophreniaBipolar DisorderCancerHead and Neck CancerGastrointestinal Cancer
- Interventions
- Behavioral: Virtual Cancer and Mental Health Tumor Board
- Registration Number
- NCT05837598
- Lead Sponsor
- Massachusetts General Hospital
- Brief Summary
This study examines the feasibility and acceptability of a virtual tumor board for cancer and mental illness for patients with serious mental illness and a new cancer diagnosis. The study also examines the impact on patient care, psychiatric symptoms, and clinician self-efficacy in managing this population.
- Detailed Description
Individuals with serious mental illness (SMI) experience increased cancer mortality because of inequities in cancer care. Access to mental health and cancer care remains inadequate. Virtual tumor boards have been associated with higher rates of patients receiving guideline-concordant cancer care, but these tumor boards have not been adapted for cancer and mental illness. A virtual cancer and mental health tumor board intervention has potential to increase access to psycho-oncology and oncology expertise, facilitate clinician communication, and may address barriers to cancer and mental health care. The purpose of this study is to examine the feasibility and acceptability of a virtual tumor board for cancer and mental illness for our target population for patients and clinicians. We will also explore changes in cancer care, psychiatric symptoms, and clinician self-efficacy in managing this population. This study is a single-arm pilot (n = 30) based at a cancer center affiliate and the surrounding community. The intervention includes proactive identification using a registry, bi-monthly virtual equity tumor board focused on cancer and mental health using HIPAA-compliant videoconference that uses co-learning, assessment of barriers to cancer care, strengths, and goals of care, creating plans that identify who is responsible for next steps and patient communication, and relaying recommendations to patients and the treating oncology team.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 30
- Age ≥ 18 years old
- Verbal fluency in English
- SMI (schizophrenia spectrum disorder, bipolar disorder, or major depressive disorder with either prior psychiatric hospitalization, history of suicide attempt/suicidal ideation, Medicaid insurance, and/or comorbid alcohol or opioid use disorder) confirmed by diagnostic evaluation of study psychiatrist
- New invasive stage I-IV breast, lung, gastrointestinal, genitourinary, or head and neck cancer (highly suspected or confirmed according to documentation by the oncologist or pathology)
- Oncology consultation at or referral to a MGH Danvers within the past 8 weeks
- Have cognitive impairment severe enough to interfere with completing brief study assessments or providing informed consent and does not have a guardian who can provide consent
- Recurrence of same cancer type
- Do not have verbal fluency in English
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Tumor Board Arm Virtual Cancer and Mental Health Tumor Board This intervention has three parts: Part 1: Proactive identification and assessment of patient needs, values, psychiatric symptoms, and illness understanding Part 2: Virtual tumor board discussion o Bring together expertise in mental illness and cancer, the interdisciplinary team will co-design an integrated cancer and mental health treatment plan. Key strategies include: addressing resource-related barriers to care, framing next steps in terms of patient values, and identifying action steps to address barriers to psycho-oncology/specialty oncology expertise Part 3: Closed Loop Communication o Tumor board recommendations shared with treating oncologist, documented in medical record, and shared with patient. Team tracks steps taken to address barriers to care and follows up with patient at 12 weeks.
- Primary Outcome Measures
Name Time Method Patient enrollment assessed by consent rate. At baseline The investigators will evaluate program feasibility through patient enrollment by examining consent rates (60% of eligible patients consent).
Patient satisfaction assessed by patient feedback questionnaire. 12 weeks from study enrollment The investigators will evaluate program acceptability through patient intervention satisfaction by a patient feedback questionnaire (exit interview surveys with participating patients regarding the usefulness of the intervention) at 12 weeks.
Patient trial completion assessed by number of patients who complete study assessments and trial procedures. 12 weeks from study enrollment The investigators will evaluate trial completion assessed by number of patients who complete study assessments and trial procedures (75% of patient participants have baseline targeted assessment, have tumor board recommendations communicated with them, and complete 12-week assessment of psychiatric symptoms and barriers to cancer care).
- Secondary Outcome Measures
Name Time Method Percentage of tumor board participants participating in tumor board session. 24 weeks from study enrollment The investigators will evaluate program feasibility by tracking percentage of tumor board participants participating in tumor board sessions (80% of participants complete intra-session feedback questionnaire).
Tumor board participant satisfaction assessed by in-session feedback questionnaire. 24 weeks from study enrollment The investigators will evaluate program acceptability by examining participant intervention satisfaction (in-session feedback questionnaire regarding the acceptability and helpfulness of the virtual tumor board model).
Number of participants contributing to multi-disciplinary representation at tumor board sessions. 24 weeks from study enrollment The investigators will evaluate program feasibility by examining the amount of multi-disciplinary representation at tumor board sessions (\>70% of sessions include representation from oncology/cancer center affiliate, community mental health, and psycho-oncology).
Volume of tumor board session attendance by tumor board participants. 24 weeks from study enrollment The investigators will evaluate program feasibility by tracking volume of tumor board session attendance (feasibility defined as participants attending 80% of sessions when patients/clients discussed).
Tumor board participant satisfaction assessed by tumor board participant feedback questionnaire. 24 weeks from study enrollment The investigators will evaluate program acceptability by examining participant intervention satisfaction (feedback questionnaire at end of study period regarding the acceptability and helpfulness of the virtual tumor board model).
Percentage of tumor board participants completing study questionnaires. 24 weeks from study enrollment The investigators will evaluate program feasibility by examining completion of study measures (70% of participants complete 12-week- and 24-week measures).
Trial Locations
- Locations (1)
Mass General/North Shore Center for Outpatient Care
🇺🇸Danvers, Massachusetts, United States