- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04596384
Home Base Telemonitoring in Gastrointestinal, Genitourinary, or Gynecologic Cancer Patients Undergoing Abdominal Surgery
Comparative Effectiveness Trial of Perioperative Telemonitoring for Functional Recovery and Symptoms
Study Overview
Status
Conditions
Detailed Description
PRIMARY OBJECTIVES:
I. Compare the impact of remote perioperative telemonitoring care versus surgeon only perioperative care on clinically significant changes in functional recovery (accelerometer daily step count) and related secondary patient-centered outcomes (sleep, sedentary time, symptom severity, symptom interference with daily activities).
II. Compare the impact of remote perioperative telemonitoring care versus surgeon only perioperative care on postoperative complications (Comprehensive Complications Index - CCI) and related secondary surgical outcomes (hospital readmission).
III. Compare early withdrawal (dropout or loss of accelerometer device) between the comparators.
IV. Explore perioperative telemonitoring care-related experiences (acceptability, technology usability, uptake/integration) among patients, families, and surgeons through qualitative focus groups and exit interviews.
OUTLINE: Patients are randomized to 1 of 2 groups.
GROUP I (REMOTE PERIOPERATIVE TELEMONITORING CARE GROUP): Before surgery, patients complete a functional and nutritional assessment. The home environment of patients will also be assessed. Based on findings, patients undergo personalized prehabilitation. Patients also wear an actigraph throughout the study to measure and record daily steps taken and sedentary time. Patients use the TapCloud application (app) on a smart device (phone, tablet) or home computer to collect, track, and report their symptoms. Based on patient input in the TapCloud app, a real-time alert is sent to a registered nurse (RN) when predetermined thresholds are met. RNs then contact the patient via the TapCloud app and further phone calls if necessary. Patients, caregivers and surgeons may also participate in a focus group in-person, via telephone, or videoconferencing.
GROUP II (SURGEON ONLY PERIOPERATIVE CARE GROUP): Patients and their families meet with the surgeon at least once before surgery. After surgery, patients are managed daily during post-operative care. Patients may receive a referral for functional and nutritional prehabilitation at the discretion of the surgeon/surgical team. Patients and their families receive instructions to follow the standard procedures for reporting problems between clinic visits, including contacting their surgical team if symptoms become severe and physical function worsens; and the use of the hospital call line to report problems. Patients, caregivers and surgeons may receive the opportunity to participate in focus group in-person, via telephone, or videoconferencing.
After completion of study, patients are followed up for 3-4 months.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Duarte, California, United States, 91010
- City of Hope Comprehensive Cancer Center
-
Lancaster, California, United States, 93534
- City of Hope Antelope Valley
-
South Pasadena, California, United States, 91030
- City of Hope South Pasadena
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Cancer patients scheduled to undergo major abdominal surgery for gastrointestinal (GI), genitourinary (GU), or gynecological (GYN) malignancies
- Ability to read and understand English or Spanish
- Patients across all stages of disease
- There are no restrictions related to performance status or life expectancy
- All subjects must have the ability to understand and the willingness to sign a written informed consent
Exclusion Criteria:
- Subjects, who in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study
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: Group I (telemonitoring program, actigraph, TapCloud)
Before surgery, patients complete a functional and nutritional assessment.
The home environment of patients will also be assessed.
Based on findings, patients undergo personalized prehabilitation.
Patients also wear an actigraph throughout the study to measure and record daily steps taken and sedentary time.
Patients use the TapCloud app on a smart device (phone, tablet) or home computer to collect, track, and report their symptoms.
Based on patient input in the TapCloud app, a real-time alert is sent to an RN when predetermined thresholds are met.
RNs then contact the patient via the TapCloud app and further phone calls if necessary.
Patients, caregivers and surgeons may also participate in a focus group in-person, via telephone, or videoconferencing.
|
Ancillary studies
Other Names:
Ancillary studies
Complete a functional assessment
Wear an actigraph
Complete a nutritional assessment
Other Names:
Use TapCloud app
|
Active Comparator: Group II (surgeon-only perioperative care program)
Patients and their families meet with the surgeon at least once before surgery.
After surgery, patients are managed daily during post-operative care.
Patients may receive a referral for functional and nutritional prehabilitation at the discretion of the surgeon/surgical team.
Patients and their families receive instructions to follow the standard procedures for reporting problems between clinic visits, including contacting their surgical team if symptoms become severe and physical function worsens; and the use of the hospital call line to report problems.
Patients, caregivers and surgeons may receive the opportunity to participate in focus group in-person, via telephone, or videoconferencing.
|
Ancillary studies
Other Names:
Ancillary studies
Participate in a surgeon-only perioperative care program
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Maximum CCI
Time Frame: Up to 30 days post-discharge
|
Maximum CCI will be categorized as above versus below 15, and logistic regression will be used to evaluate the effect of study intervention.
|
Up to 30 days post-discharge
|
Change in Daily Step Count
Time Frame: Baseline up to day 14
|
Will calculate percent change from preoperative baseline in daily step count during the first 2 weeks post-discharge from hospital.
Will use generalized linear mixed modeling (with treatment and covariates as fixed factors, patient identification as random factor).
|
Baseline up to day 14
|
Time to Early Withdrawal
Time Frame: Up to 4 months
|
Analyzed using proportional hazards regression.
|
Up to 4 months
|
Qualitative Data
Time Frame: Up to 4 months
|
Qualitative data from exit interviews and focus groups will be analyzed using the conventional content analysis approach.
|
Up to 4 months
|
Post-operative Complications
Time Frame: Up to 30 days after surgery
|
Assessed using the Comprehensive Complications Index (CCI) which summarizes the entire patient postoperative experience with respect to complications (on a scale from 0 to 100), and is based on the established Clavien-Dindo classification.
For CCI score: Higher = worse
|
Up to 30 days after surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to Hospital Readmission
Time Frame: Up to 90 days post-discharge
|
Will be subjected to survival analysis.
|
Up to 90 days post-discharge
|
Change in Sedentary Time
Time Frame: Baseline up to 4 months
|
Assessed using the Actigraph GT9X Link.
Data capture will focus on the following: 1) number of steps taken per day and 2) sedentary time.
Recommended activity counts per minute (cpm) cutpoints will be used to categorize sedentary time (< 100 cpm) from light-intensity physical activity (100-1951 cpm) and moderate/vigorous intensity physical activity (>=1952 cpm).
|
Baseline up to 4 months
|
Change in General Symptoms
Time Frame: Baseline up to 4 months
|
Assessed using the MD Anderson Symptom Inventory.
|
Baseline up to 4 months
|
Change in Disease-specific Symptoms
Time Frame: Baseline up to 4 months
|
Assessed using the MD Anderson Symptom Library Items.
|
Baseline up to 4 months
|
Change in Sleep
Time Frame: Baseline up to 4 months
|
Assessed using the MD Anderson Symptom Inventory.
|
Baseline up to 4 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Virginia Sun, City of Hope Comprehensive Cancer Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Estimated)
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
- 20370 (Other Identifier: City of Hope Medical Center)
- P30CA033572 (U.S. NIH Grant/Contract)
- NCI-2020-07889 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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