- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03661242
Integration of Exercise Into Cancer Care: A Shared Care Model
Study Overview
Detailed Description
Numerous organizations, including the American Cancer Society, American College of Sports Medicine, National Comprehensive Cancer Network, U.S. Department of Health and Human Resources and Oncology Nursing Society have endorsed physical activity for cancer patients both when undergoing treatment and during the survivorship phase of care. Previous studies have consistently found physical activity to be associated with improved quality of life. However, current guidelines for oncologist prescribed exercise are vague and not supported with adequate training and/or education.
A focus group study previously conducted at Gundersen Health System found that oncologists' reluctance to discuss physical activity with patients is rooted in their own ability to safely guide patients through an exercise program. Cancer patients have also reported uncertainty about what types, frequency and intensity of physical activity in which to engage and it has been suggested that a referral process is critical to inclusion of exercise prescription into cancer care. Investigator´s previous study, along with others, have found that patients want advice and support about exercise while enduring the physiological and psychological side effects of treatment, yet do not want to be referred elsewhere. Thus, it seems there is a dilemma of translating safe and sustainable physical activity into standard cancer care.
A potential solution to this perceived shortcoming is a shared care model of cancer care delivery, wherein an oncologist is partnered with a certified exercise physiologist or physical therapist to develop an individualized, holistic care plan for each patient. In addition to providing the patient with standard of care cancer therapy as prescribed by the oncologist, the shared care model will also provide the patient with a customized physical activity plan developed by the exercise physiologist in consultation with the oncology staff and after meeting with the patient during a regularly scheduled oncology office visit. In this study the Investigators propose to investigate the impact of shared care visits with an oncologist and exercise physiologist on quality of life and functional capacity during cancer treatment. This model provides patients with easy access to the advice and support they desire without the need for additional referrals and travel, while ensuring a comprehensive assessment of risks and the development of safe progression of activities. Plan is to recruit total of 120 patients.
Statistical analysis will utilized a mix of descriptive and comparative statistics. Descriptive metrics will include means and associated 95% confidence intervals, medians and frequency counts. Comparison of demographic and clinical factors between study groups will utilize the Chi-square test for categorical data, the Wilcoxon rank sum test or Kruskal-Wallis test for ordinal discrete or non-normally distributed continuous data and Student's t-test or ANOVA for normally distributed continuous data. Evaluation of the primary outcome will utilize repeated measures ANOVA to compare the change overall quality of life over the study period, assessed via the FACT-G instrument, between the study groups. A p-value < 0.05 will be used as the threshold for statistical significance for all tests.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Reykjavik, Iceland, 101
- Recruiting
- Landspitali - The National University Hospital of Iceland
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Contact:
- Halla Arnardottir
- Phone Number: +354-543-1000
- Email: hallarn@lsh.is
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Contact:
- Eyrun Steinsson
- Phone Number: 1465 +354-543-1000
- Email: eyrunst@lsh.is
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Sub-Investigator:
- Runolfur Palsson, MD
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-
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Wisconsin
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La Crosse, Wisconsin, United States, 54601
- Recruiting
- Gundersen Health System
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Contact:
- Kurt Oettle, MD
- Phone Number: 608-782-7300
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Contact:
- Amee Vang, MPH
- Phone Number: 608-775-7816
- Email: cavang@gundersenhealth.org
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 18 years and older
- Pathologic confirmed cancer diagnosis
- Patients receiving adjuvant treatment (chemotherapy and/or radiation) with curative intent
- ECOG performance status 0-2
Exclusion Criteria:
- Unable to ambulate
- Comorbidity contraindicated PA as per treating physician
- Non-English speaker
- Receiving maintenance chemotherapy
- Breast cancer diagnosis
- Pregnant women
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Standard of care
No intervention
|
|
Active Comparator: Shared care
Clinic visit with Clincal Exercise Physiologist or physical therapist who does assessment and prescripes individulized physical activity plan
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Patients in shared care arm has regular combined visits with Oncologist and Clincal Exercise Physiologist (CEP).
Individual physical activity plan developed by CEP for patients in shared care arm.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Functional Assessment of Cancer Therapy - General (FACT-G QOL) measurement.
Time Frame: Month 0 (first visit), month 1, month 3, month 6, month 9, month 12
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Change in score of FACT-G QOL measurement.
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Month 0 (first visit), month 1, month 3, month 6, month 9, month 12
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
6-minute walk test
Time Frame: Month 0 (first visit), month 1, month 3, month 6, month 9, month 12
|
Change in 6-minute walk test
|
Month 0 (first visit), month 1, month 3, month 6, month 9, month 12
|
International Physical Activity Questionnaire (IPAQ) score
Time Frame: Month 0 (first visit), month 1, month 3, month 6, month 9, month 12
|
Change in International Physical Activity Questionnaire (IPAQ) score
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Month 0 (first visit), month 1, month 3, month 6, month 9, month 12
|
Patient Health Questionnaire 9 (PHQ-9) score
Time Frame: Month 0 (first visit), month 1, month 3, month 6, month 9, month 12
|
Change in Patient Health Questionnaire (PHQ) score
|
Month 0 (first visit), month 1, month 3, month 6, month 9, month 12
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Agnes Smaradottir, MD, Landspitali University Hospital
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
Other Study ID Numbers
- LSH-18-001
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.
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