A Randomized Controlled Trial of Clinical Nurse Specialist Led Early Palliative Survivorship Care for Patients With Advanced Cancer
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 100
- 试验地点
- 2
- 主要终点
- participant reported symptom burden
研究概览
简要总结
The purpose of the randomized control trial is to estimate the effect of an oncology clinical nurse specialist-led early intervention multidisciplinary approach to palliative and survivorship care within two previously identified and validated patient groups having metastatic solid tumor malignancy on patient-reported symptom burden, patient-reported overall quality of life (QOL), distress, and overall survival. The primary hypothesis is that the effect of an oncology clinical nurse specialist- led early intervention multidisciplinary palliative and survivorship care model will be significantly higher, as compared to the standard of care approach to palliative and survivorship care, on the primary endpoint of patient-reported symptom burden for patients with metastatic solid tumor malignancy within favorable and very favorable risk groups. Symptom burden includes pain, tiredness, drowsiness, nausea, lack of appetite, depression, anxiety, shortness of breath, and wellbeing.
详细描述
OVERVIEW OF DESIGN SUMMARY This is an unblinded randomized control trial estimating the effect of an oncology clinical nurse specialist- led early intervention multidisciplinary approach to palliative and survivorship care within two previously identified and validated patient groups having metastatic solid tumor malignancy on patient-reported symptom burden, patient-reported quality of life (QOL), distress, and overall survival.
Randomization Method and Blinding Subjects will be randomized using a stratified approach consisting of two strata- subjects enrolled from inpatient recruitment and subjects enrolled from outpatient recruitment. Within each stratum a block randomization design (with varying block sizes of 4, 6, and 8). Block sizes will be masked to research team as patient allocation to treatment arm is not blinded. Stratified randomization with varying block sizes will reduce potential of nonequivalence in treatment arms secondary to the heterogeneity of the population being sampled.
Subject Recruitment Plans The researchers will recruit n= 100 patients from the favorable and very favorable NEAT Groups. Recruitment will occur upon admission for inpatients when diagnosed at stage 4 with metastatic disease (approximately 30% of total way of entry into our facility's radiation oncology patient population) and outpatient (mainly- approx. 70% of way of entry into our facility's radiation oncology patient population). All eligible adult patients with metastatic disease seen in radiation oncology will be offered enrollment in this trial.
Risks and Benefits The standard of care comparator arm is usual clinical care using NCCN guidelines and evidence-based practice for palliative and survivorship care. The usual practice (standard of care) for patients treated with distant metastases. Typically, there are physician and nursing visits at 3 months, 9 months, 15 months, and 24 months although this of course varies by diagnosis and whether patients require further treatment.
The risks associated with participation in the study involve:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •adult patients (21 yrs and over)
- •metastatic solid tumor malignancy with very favorable and favorable prognostic curves
- •under the care of GSUH oncology and radiation oncology clinicians
排除标准
- •patients with metastatic solid tumor malignancy who are < 21 yrs of age
- •adult patients with metastatic solid tumor malignancy who are in standard risk and unfavorable prognostic curves
- •patients not under the care of GSUH oncology and radiation oncology clinicians
结局指标
主要结局
participant reported symptom burden
时间窗: 24 months
The Edmonton Symptom Assessment System- Revised (ESAS-r) will be used to measure patient reported symptom burden
次要结局
- participant overall survival(60 months)
- participant reported quality of life(24 months)
- participant reported distress(24 months)
研究者
Patricia Eckardt
Research Scientist
Good Samaritan Hospital Medical Center, New York