Patient Priorities for Survivorship Care in Older Breast Cancer Survivors
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Breast Cancer Survivorship
- Sponsor
- The University of Texas Health Science Center, Houston
- Enrollment
- 120
- Locations
- 3
- Primary Endpoint
- Health status as assessed by the Functional Assessment of Cancer Therapy - Breast (FACT-B)
- Status
- Recruiting
- Last Updated
- 8 months ago
Overview
Brief Summary
The objective of this study is to adapt the Patient Priorities Care (PPC) framework to breast cancer survivorship via a user-centered approach, through an iterative process in which patients and their physicians help to refine and modify the intervention. A second objective is to evaluate the feasibility and effectiveness of the adapted PPC framework in breast cancer survivorship for older adults.
Detailed Description
In the proposed project, we will use a Patient Priorities Care framework to explore older breast cancer survivors' priorities and health care preferences for high-quality breast cancer survivorship. The framework will include two components: (1) a health priorities identification session with a facilitator, and (2) an encounter with the oncology provider to discuss changes in the patient's care plan to align it with his/her priorities. Our overall hypothesis is that prioritizing patients' priorities is feasible and facilitates individualized survivorship care for older women with breast cancer and multiple chronic conditions. An advisory panel composed of oncologists, geriatricians, and patient advocates will provide regular feedback throughout the refinement and adaptation of the Patient Priorities Care framework to the breast cancer survivorship context and engage in an iterative process of development. After incorporating feedback from the stakeholder panel to create an adapted version of the framework, we will carry out a randomized quality improvement project with the objective of evaluating the feasibility of using the framework in the context of breast cancer survivorship and provide empirical estimates of treatment effect sizes by measuring treatment burden and quality of life at 3 months, adherence to basic and priorities driven survivorship care recommendations at 12 months. Ultimately, the results of this project will provide initial direction for intended improvement, which will be verified in a larger, future trial.
Investigators
Dana Giza
Assistant Professor
The University of Texas Health Science Center, Houston
Eligibility Criteria
Inclusion Criteria
- •able to write and speak English
- •Stage DCIS/I/II/III breast cancer diagnosis
- •3 months from active cancer therapy (including first or second-line treatment chemotherapy, radiation and/or surgery, or multimodal treatment) up to 10 years since completing treatment
- •≥3 documented comorbidities by chart review, or taking ≥10 medications, have ≥ 1 hospitalization over the past year, ≥ 2 emergency department visits over the past year, seen by \> 2 specialists over the past year
- •able to provide consent
Exclusion Criteria
- •currently on active cancer therapy (including first or second-line treatment chemotherapy, radiation and/or surgery, or multimodal treatment)
Outcomes
Primary Outcomes
Health status as assessed by the Functional Assessment of Cancer Therapy - Breast (FACT-B)
Time Frame: 6 months
The Functional Assessment of Cancer Therapy- Breast (FACT-B) is a standardized approach to objectively evaluate and quantify the overall health status of patients with subscales measuring physical, social, emotional, and functional well-being. Total score ranges from 0 to 148, where a higher score indicates a better outcome.
Treatment burden as assessed by the treatment burden questionnaire (TBQ)
Time Frame: 6 months
The treatment burden questionnaire (TBQ) measures perceptions of burden of overall care (for example, medication taking, self monitoring, visits to the provider, tests, tasks to access and coordinate care). Total score ranges from 0 to 150, and a higher score indicates greater perceived burden.
Secondary Outcomes
- Number of participants who adhere to survivorship basic recommendations(from baseline to 12 months)
- Number of participants who adhere to priorities-driven survivorship recommendations(from baseline to 12 months)