- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03229343
Impact of a Systematic Palliative Care on Quality of Life, in Advanced Idiopathic Pulmonary Fibrosis. (PALIF)
Impact of a Systematic Palliative Care on Quality of Life, in Advanced Idiopathic Pulmonary Fibrosis (IPF). A Randomized Multi-center Trial.
Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a survival median between 2 and 4 years which leads to a profound alteration of the quality of life.
In thoracic oncology, the systematic and early intervention of a palliative care team result in an improvement of quality of life for patients.
In the princeps study published in 2010, the early intervention of a dedicated palliative care team was compared to standard care in a randomized trial of 150 patients and shows a significant improvement : (i) of quality of life (main objective), (ii) of depression scores and even overall survival (11.6 months vs. 8.9 months, P = 0.02), (iii) a benefit in terms of understanding the diagnosis and therapeutic goals (3), (iv) diminution of adapted hospitalization in end of life (in emergency or not).
Considering some analogy points between IPF and advanced lung cancer (prognosis, respiratory symptom, psychological burden), it seemed reasonable to assume that the joint systematic intervention of chest physician and palliative care team may provide a significant benefit in terms of quality of life for patients with severe IPF.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a survival median between 2 and 4 years which leads to a profound alteration of the quality of life. This alteration results from different consequences of the IPF: progressive shortness of breath, irritative cough refractory to treatments, exhaustion, limitation of activity, social isolation, and psychic consequences such as fear, anxiety and depression.
The only current curative treatment of the disease is pulmonary transplantation, but it's only feasible for a minority of patients. Anti-fibrotic drugs, such as pirfenidone and nintedanib, are likely to slow the progression of IPF but have no impact on patients' quality of life.
The symptomatic treatment aimed at relieving respiratory discomfort and the patient's quality of life is therefore fundamental, and the IPF meets in many ways the challenges of lung cancer.
In thoracic oncology, the systematic and early intervention of a palliative care team result in an improvement of quality of life for patients.
In the princeps study published in 2010, the early intervention of a dedicated palliative care team was compared to standard care in a randomized trial of 150 patients and shows a significant improvement : (i) of quality of life (main objective), (ii) of depression scores and even overall survival (11.6 months vs. 8.9 months, P = 0.02), (iii) a benefit in terms of understanding the diagnosis and therapeutic goals (3), (iv) diminution of adapted hospitalization in end of life (in emergency or not).
Considering some analogy points between IPF and advanced lung cancer (prognosis, respiratory symptom, psychological burden), it seemed reasonable to assume that the joint systematic intervention of chest physician and palliative care team may provide a significant benefit in terms of quality of life for patients with severe IPF.
Objective:
To investigate the benefit on quality of life, evaluated after 6 months, of a systematic, formalized and joint intervention of a palliative intervention staff and a chest physician team compared to standard care for patients with severe IPF.
Secondary endpoints
To evaluate the benefit of the systematic, formalized and joint intervention of a palliative care team and a chest physician team on:
- Mood and depression
- Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives regarding end-of-life
- Respiratory symptoms (cough and dyspnea)
- The course of care, the use of palliative care stays and the duration of hospital stays (number and duration of hospitalizations).
- Overall survival and place of death.
- Carry out a medico-economic study evaluating the incremental cost-utility and cost-effectiveness ratio (overall survival criterion)
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Boris Duchemann, Dr
- Phone Number: 01 48 95 50 32
- Email: boris.duchemann@aphp.fr
Study Contact Backup
- Name: Nacira DARGHAL, PhD
- Phone Number: 01 48 95 74 73
- Email: nacira.darghal@aphp.fr
Study Locations
-
-
-
Aulnay-sous-Bois, France, 93602
- Not yet recruiting
- Centre Hospitalier Robert Ballanger
-
Contact:
- Jérome VIRALLY, Pr
-
Bobigny, France, 93000
- Recruiting
- Hôpital Avicenne
-
Contact:
- Boris DUCHEMANN, PI
-
Le Chesnay, France, 78150
- Not yet recruiting
- Centre Hospitalier de Versailles André Mignot
-
Contact:
- Nathalie MICHENOT, Dr
-
Lyon, France, 69677
- Recruiting
- Hopital Louis Pradel
-
Contact:
- Vicent COTTIN, Pr
-
Marseille, France, 13015
- Not yet recruiting
- Hôpital Nord
-
Contact:
- Martine REYNAUD GAUBERT, Pr
-
Melun, France
- Recruiting
- Hopital Marc Jacquet
-
Contact:
- Djamel BENNEGADI, Dr
-
Paris, France, 75020
- Not yet recruiting
- Hôpital Tenon
-
Contact:
- Jean Marc NACCACHE, Pr
-
Paris, France, 75015
- Not yet recruiting
- Hôpital GEORGES POMPIDOU (HEGP)
-
Contact:
- Dominique ISRAEL-BIET, Pr
-
Rennes, France, 35033
- Recruiting
- Hôpital Pontchaillou
-
Contact:
- Stéphane JOUNEAU, Pr
-
Saint-Denis, France, 93200
- Not yet recruiting
- Hôpital Delafontaine
-
Contact:
- Isabelle LERAT, Dr
-
Toulouse, France, 31059
- Not yet recruiting
- Hôpital Larrey
-
Contact:
- Grégoire PREVOT, Dr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age> 40 years
- Patient with confirmed diagnosis of IPF according to the American Thoracic Society (ATS) / European Respiratory Society (ERS) / Japanese Respiratory Society (JRS) / Latin American Thoracic Association (ALAT) criteria. The patient may be included regardless of the date of diagnosis.
- Advanced IPF with Forced Vital Capacity (FVC) <50%" of predicted value and / or Diffusing capacity for carbon monoxide ((DLCO) <30% of predicted value or inability to achieve the Functional Respiratory Investigations (EFR) due to respiratory severity. EFR dated less than 3 months.
- Absence of argument for acute or subacute exacerbation in the last 6 months.
- Patient who can be followed in ambulatory consultation/ outpatient consultation.
- Informed consent signed (signed by the patient or in the presence of a third party for patients who are poorly fluent in French).
- Affiliation to the social security system.
Exclusion Criteria:
- Patient unable to respond to quality of life questionnaires.
- Inability (physical or mental) to give a written informed consent.
- Acute exacerbation of fibrosis in the previous 6 months.
- Patient eligible for a pulmonary transplant.
- Participation in other therapeutic trial
- Patient cannot be followed in ambulatory consultation.
- Patient under trustee
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Experimental
Supportive care, systematic and joint to pneumological consultation, monthly, starting at M0 and continuing up to M6.
|
supportive care, systematic and joint to pneumological consultation, monthly, starting at M0 and continuing up to M6.
|
No Intervention: standard
pneumological consultation performed at M0, M3 and M6
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The benefit of a systematic, formalized and joint intervention of a palliative intervention staff and a chest physician team on quality of life, evaluated after 6 months by the Short Form (36) Health Survey.
Time Frame: at 6 months after inclusion
|
The Short Form (36) Health Survey is a 36-item, patient-reported survey of patient health.
The Short Form (36) Health Survey consists of eight scaled scores, which are the weighted sums of the questions in their section.
Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight.
The lower the score the more disability.
The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.
The eight sections are: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, mental health.
This score has already been used for IPF
|
at 6 months after inclusion
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Mood and depression
Time Frame: at 3 and 6 months after inclusion
|
evaluated by the Hospital Anxiety and Depression questionnaire.
|
at 3 and 6 months after inclusion
|
The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives.
Time Frame: at 3 and 6 months after inclusion
|
the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives will be evaluated by the illness understanding questionnaire.
|
at 3 and 6 months after inclusion
|
The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Respiratory symptoms (dyspnea)
Time Frame: at 3 and 6 months after inclusion
|
The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Respiratory symptoms (dyspnea) will be evaluated by St George's respiratory questionnaire (SGRQ) and Transition Dyspnea Index (TDI)
|
at 3 and 6 months after inclusion
|
The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the course of care.
Time Frame: at 3 and 6 months after inclusion
|
the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the course of care, the use of palliative care stays and the duration of hospital stays (number and duration of hospitalizations)
|
at 3 and 6 months after inclusion
|
The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the Overall survival.
Time Frame: between inclusion and date of death or last news. (survival follow-up visit at month 12)
|
the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the Overall survival measured between inclusion and date of death or last news.
|
between inclusion and date of death or last news. (survival follow-up visit at month 12)
|
Carry out a medico-economic study evaluating the incremental cost-utility and cost-effectiveness ratio (overall survival criterion)
Time Frame: at 3 and 6 months after inclusion
|
This outcome is evaluated by the medico-economic questionnaire : EuroQol five dimensions questionnaire (EQ-5D)
|
at 3 and 6 months after inclusion
|
Collaborators and Investigators
Investigators
- Principal Investigator: Boris Duchemann, Assistance Publique - Hôpitaux de Paris
Publications and helpful links
General Publications
- Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010 Aug 19;363(8):733-42. doi: 10.1056/NEJMoa1000678.
- Swigris JJ, Brown KK, Behr J, du Bois RM, King TE, Raghu G, Wamboldt FS. The SF-36 and SGRQ: validity and first look at minimum important differences in IPF. Respir Med. 2010 Feb;104(2):296-304. doi: 10.1016/j.rmed.2009.09.006. Epub 2009 Oct 7.
- Swigris JJ, Kuschner WG, Jacobs SS, Wilson SR, Gould MK. Health-related quality of life in patients with idiopathic pulmonary fibrosis: a systematic review. Thorax. 2005 Jul;60(7):588-94. doi: 10.1136/thx.2004.035220.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- P150965
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Idiopathic Pulmonary Fibrosis
-
St. Antonius HospitalZonMw: The Netherlands Organisation for Health Research and Development; Boeringer...RecruitingPulmonary Fibrosis Idiopathic FamilialNetherlands
-
Wake Forest University Health SciencesMayo Clinic; The University of Texas Health Science Center at San AntonioCompletedIdiopathic Pulmonary Fibrosis (IPF)United States
-
Sheba Medical CenterUnknownIDIOPATHIC PULMONARY FIBROSISIsrael
-
Theravance BiopharmaTerminatedIdiopathic Pulmonary Fibrosis (IPF)United Kingdom
-
University of California, San FranciscoCompletedIdiopathic Pulmonary Fibrosis (IPF)United States
-
BiogenCompletedIdiopathic Pulmonary Fibrosis (IPF)United States
-
Liminal BioSciences Ltd.CompletedIdiopathic Pulmonary Fibrosis (IPF)Canada
-
Bristol-Myers SquibbCompletedIdiopathic Pulmonary Fibrosis (IPF)United States
-
Angion Biomedica CorpNot yet recruitingIdiopathic Pulmonary Fibrosis (IPF)
-
Xfibra, Inc.Not yet recruitingIdiopathic Pulmonary Fibrosis (IPF)
Clinical Trials on Supportive care
-
Memorial Sloan Kettering Cancer CenterUConn HealthActive, not recruitingAdvanced CancerUnited States
-
Centre Henri BecquerelRecruiting
-
Kaleido BiosciencesCompletedMild-to-Moderate COVID-19United States
-
Kaleido BiosciencesCompletedMild-to-moderate COVID-19United States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Completed
-
University of Colorado, DenverNational Institute of Nursing Research (NINR); University of California, San...CompletedParkinson Disease | Alzheimer Disease | Lewy Body Disease | Parkinsonism | Supranuclear Palsy, Progressive | Parkinsonism Vascular | Multiple System Atrophy | Corticobasal Degeneration | Frontotemporal Dementia | Primary Progressive Aphasia | Vascular DementiaUnited States
-
Kaleido BiosciencesCompleted
-
VA Office of Research and DevelopmentCompletedLung CancerUnited States
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)CompletedOvarian Carcinoma | Malignant Uterine Neoplasm | Malignant Female Reproductive System Neoplasm | Ovarian Neoplasm | Uterine Neoplasm | Female Reproductive System Neoplasm | Suspicious for MalignancyUnited States
-
Susanne Schmidt PedersenOdense University Hospital; Zealand University Hospital; Aarhus University Hospital and other collaboratorsCompletedDistress | Implantable Defibrillator UserDenmark