Impact of Nationwide Enhanced Implementation of Best Practices in Pancreatic Cancer Care (PACAP-1)
- Conditions
- Carcinoma, Pancreatic Ductal
- Interventions
- Other: Best practices in pancreatic cancer care
- Registration Number
- NCT03513705
- Brief Summary
PACAP-1 will evaluate to what extent an enhanced implementation of best practices in pancreatic cancer care leads to a prolonged survival and improvement of quality of life as compared to current practice.
- Detailed Description
Rationale:
The Dutch Pancreatic Cancer Project (PACAP) is an initiative of the Dutch Pancreatic Cancer Group and was officially launched in July 2014. PACAP is 1 of the largest nationwide collaborative outcomes registration and biobanking projects on pancreatic and periampullary cancer worldwide and includes the Dutch Pancreatic Cancer Audit (DPCA), the Patient Reported Outcome Measures (PROMs), an online expert panel, and the Netherlands Cancer Registry (NCR, Netherlands Comprehensive Cancer Organization; IKNL). During the first 3 years of PACAP, regional variations in treatment and guideline (non-)compliance were observed. These differences may lead to differences in survival and quality of life of pancreatic cancer patients throughout the Netherlands. From PACAP data and literature, best practices for pancreatic cancer care have been identified.
Objective:
The aim of PACAP-1 is to evaluate to what extent an enhanced implementation of best practices in pancreatic cancer care in the Netherlands leads to a prolonged survival and improvement of quality of life as compared to current practice.
Study design:
The PACAP-1 trial is a nationwide stepped-wedge cluster randomized controlled trial. In a per center stepwise and randomized manner, best practices in pancreatic cancer care are implemented in all 17 Dutch pancreatic centers. A regional pancreatic cancer team will be established per pancreatic center that functions as point of contact for peripheral centers in the region. Patient outcomes and compliance will be monitored by the registries founded in the PACAP initiative.
Study Population:
Prospective cohort of all pancreatic cancer patients diagnosed and treated in the Netherlands.
Interventions:
Best practices will be implemented in 3 key medical specialties in pancreatic cancer care: medical oncology, surgery and gastroenterology. Best practices will be implemented in centers during a 6 week intensive initiation period which includes monitoring, return visits, provider feedback in combination with education and reminders. The best practices follow the Dutch guideline on pancreatic cancer and the current state of the literature and can be executed without additional overall costs per center.
Main study outcomes:
The primary outcome is 1-year overall survival. Secondary outcomes include quality of life (first secondary outcome), 3- and 5-year overall survival and success of implementation of every PACAP-1 intervention and participation in DPCG randomized trials.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 4000
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Best practice Best practices in pancreatic cancer care Enhanced implementation of best practices in pancreatic cancer care
- Primary Outcome Measures
Name Time Method 1-year overall survival 1-year Overall survival 1-year after diagnosis of pancreatic cancer
- Secondary Outcome Measures
Name Time Method Effect of implementation of best practices Through study completion, on average up to 25 months Proportion of patients that underwent the separate best practice interventions if applicable
5-year overall survival 5-year Overall survival 5-year after diagnosis of pancreatic cancer
Complications Through study completion, on average up to 25 months Complications of chemotherapy (toxicity grade 3-4 and type of toxicity) and biliary stent placement
3-year overall survival 3-year Overall survival 3-year after diagnosis of pancreatic cancer
Registry outcomes Through study completion, on average up to 25 months Best practice registrations measured through the Netherlands Cancer Registry
Use of smartphone application Through study completion, on average up to 25 months
Trial Locations
- Locations (17)
Leiden University Medical Center
🇳🇱Leiden, Netherlands
Maasstad Ziekenhuis
🇳🇱Rotterdam, Netherlands
Erasmus Medical Center
🇳🇱Rotterdam, Netherlands
Catharina
🇳🇱Eindhoven, Netherlands
University Medical Center Groningen
🇳🇱Groningen, Netherlands
Maastricht University Medical Center
🇳🇱Maastricht, Netherlands
Tjongerschans
🇳🇱Heerenveen, Netherlands
Isala Klinieken
🇳🇱Zwolle, Netherlands
RAKU (University Medical Center Utrecht and Sint Antonius Ziekenhuis)
🇳🇱Utrecht, Netherlands
Radboud University Medical Center
🇳🇱Nijmegen, Netherlands
Amphia
🇳🇱Breda, Netherlands
Onze Lieve Vrouwen Gasthuis
🇳🇱Amsterdam, Netherlands
VU Medical Center
🇳🇱Amsterdam, Netherlands
Reinier de Graaf Gasthuis
🇳🇱Delft, Netherlands
Academic Medical Center
🇳🇱Amsterdam, Netherlands
Jeroen Bosch Ziekenhuis
🇳🇱Den Bosch, Netherlands
Medisch Spectrum Twente
🇳🇱Enschede, Netherlands