- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03104114
Pharmacist-led Intervention on Adherence in Patients Undergoing Treatment With an Oral Oncology Medication (BSPAP)
July 30, 2019 updated by: Boston Medical Center
Evaluating Adherence and Persistence in Patients Receiving Oral Oncolytic Therapy in a Safety Net Hospital's Pharmacist-driven Medication Management Program
Boston Medical Center provides care to cancer patients on oral cancer medications through the use of Boston Medical Center Specialty Pharmacy (BMC SP).
The use of oral medications in cancer treatments is relatively new and unfortunately, very little is known about adherence in cancer patients.
This study will evaluate the influence of a pharmacist-driven medication management program on adherence and persistence rates.
Boston Medical Center's Specialty Pharmacy Adherence Program (B-SPAP), will utilize a high-touch counseling model involving clinical pharmacist that will focus on educating patients about their oral cancer treatments.
The program will require face-to-face counseling with a pharmacist, through the use of a proven patient teaching tool, prior to initiating treatment with oral oncolytic treatments and, periodically thereafter, based on protocol.
This study will help improve our understanding of the role of the pharmacist in cancer patients.
In addition, the study will help identify independent factors that may contribute or impact adherence.
The outcomes of this program will be compared to a historical control group of patients that have already received treatment for their cancer through the BMC Specialty Pharmacy.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Boston Medical Center's Specialty Pharmacy Adherence Program (B-SPAP) will focus on improving adherence and persistence through the implementation of a high-touch program.
In order to be eligible for the program, patients must be initiated on oral chemotherapy or targeted therapy with a life expectancy >6 months.
All patients will be administered a Patient Activation Measure (PAM) 13 survey prior to consultation.
Patients eligible for our program will receive a 30-60 minute pharmacist consultation prior to initiation of treatment.
The pharmacy consultation includes, but is not limited to the dissemination of medical information utilizing a standardized counseling checklist, supplying of patient education materials, pharmacist-led interventions, and/or the use of other materials or devices that may improve patient adherence.
All counseling checklists and monitoring will be standardized and approved by a multidisciplinary oncology team.
At week 1, 2, and 4, patients will be contacted by the pharmacist for an assessment of treatment goals; monthly contacts will continue thereafter by either a specialty pharmacist or certified pharmacy technician.
Scheduled follow up visits with the consulting pharmacist will be made at months 3, 6 and 12. Prior to the scheduled pharmacist consultation, patients will be administered the PAM 13 survey.
Patients with a treatment gap >37 days will be referred to the consulting pharmacist for follow up.
The consulting pharmacist will attempt to contact the patient via telephone for an assessment of adherence and adverse drug-related events.
If patients experience a treatment gap >45, then the patient will be contacted and scheduled for a pharmacist consultation, additionally, the prescribing provider will be notified.
All consultations and interventions will be documented in the hospital's electronic medical record system, EPIC®.
Study Type
Interventional
Enrollment (Actual)
216
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Massachusetts
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Boston, Massachusetts, United States, 02118
- Boston Medical Center
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Pharmacist-intervention group
Inclusion Criteria:
- Treatment with 1 or more oral oncology agents. Oral oncology agent defined as medication taken mouth with the purpose to treat a patient's cancer
- Treatment dispensed through the BMC Specialty Pharmacy
- Age>18 years
- Life expectancy >6 months
- Patients must have ability to give written consent, or, must have a legally authorized representative
Exclusion Criteria:
- Treatment indicated for neoadjuvant, adjuvant, peri-operative treatment
- Concurrent radiation treatment
- Patients that are unable to have oral oncology agents dispense through BMC Specialty Pharmacy
Historical Control:
- 2 controls:1 intervention match
- Matched to a patient in intervention group based on drug type
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: HEALTH_SERVICES_RESEARCH
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
PLACEBO_COMPARATOR: Historical Control
Pharmacy care was standard, high-touch model where an institutional specialty pharmacy contact patients via telephone.
Standard adherence and counseling was offered over the phone to patients.
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Patients that did not receive in-person motivational counseling support from a clinical pharmacist prior and during treatment
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EXPERIMENTAL: Pharmacist-intervention
In-person counseling with a clinical pharmacist prior and during treatment with an oral oncology medication.
Patients meet with a clinical pharmacist prior, at month 3 and month 6 during the study.
|
A clinical pharmacist provides patients with motivational counseling regarding their cancer treatments.
Patients will be asked to complete three different surveys throughout the study; surveys focus on social support systems and both provider- and pharmacist-patient relationships
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Medication Possession Ratio
Time Frame: Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
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MPR >80%
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Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
|
Persistence rate
Time Frame: Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
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allowance of 45 day time gap
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Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Health-belief model
Time Frame: Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
|
PAM-13 surveys
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Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
|
Provider-patient relationship
Time Frame: Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
|
Trust-in-physician survey
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Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
|
Pharmacist-patient relationship
Time Frame: Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
|
Pharmacist satisfaction survey
|
Month 0(time of first dispense) to month 12 or discontinuation of medication, whichever occurs first
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: scott gould, PharmD, Boston Medical Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
May 2, 2017
Primary Completion (ACTUAL)
February 15, 2019
Study Completion (ACTUAL)
February 15, 2019
Study Registration Dates
First Submitted
March 23, 2017
First Submitted That Met QC Criteria
April 3, 2017
First Posted (ACTUAL)
April 7, 2017
Study Record Updates
Last Update Posted (ACTUAL)
August 1, 2019
Last Update Submitted That Met QC Criteria
July 30, 2019
Last Verified
July 1, 2019
More Information
Terms related to this study
Other Study ID Numbers
- H-35671
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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