Tato stránka byla automaticky přeložena a přesnost překladu není zaručena. Podívejte se prosím na anglická verze pro zdrojový text.

Developing and Testing the Effectiveness of Smart Healthcare Assisted Individualized Symptom Management Education and Home-based Exercise on Frailty, Treatment-related Adverse Events and Quality of Life in Advanced Gastric Cancer Patients Receiving Immunotherapy

23. července 2026 aktualizováno: Taipei Veterans General Hospital, Taiwan

The goal of this randomized controlled intervention is to develop and evaluate the effectiveness of the nurse-led with AI chatbot Individualized Symptom Management Education and Home-based Exercise (AI-ISME&HE) based on The Theory of Symptom Self-Management (TSSM) on frailty, self-efficacy in cancer care, trAE, and quality of life in advanced gastric cancer patients receiving immunotherapy. The main questions it aims to answer are:

  • Can AI-ISME&HE reduces frailty in advanced gastric cancer patients receiving immunotherapy?
  • Can AI-ISME&HE increases quality of life in advanced gastric cancer patients receiving immunotherapy?
  • Can AI-ISME&HE increases self-efficacy in advanced gastric cancer patients receiving immunotherapy?
  • Can AI-ISME&HE reduces all-caused death in advanced gastric cancer patients receiving immunotherapy within two years? Researchers will compare usual routine care to see if AI-ISME&HE can reduce frailty, all-caused death and increase quality of life and self-efficacy.

Participants will not be blinded, but the outcome evaluator will be blinded. The participants will be asked to complete three tasks for 12 weeks:

  • Self-reporting treatment-related adverse events
  • Interacting with AI-ISME&HE for seeking information related to self-management educational materials, including symptom management with the most reported trAEs and prevention from frailty
  • ViviFrail-based exercise

Přehled studie

Postavení

Zatím nenabíráme

Podmínky

Intervence / Léčba

Typ studie

Intervenční

Zápis (Odhadovaný)

110

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

  • Jméno: Shiow-Ching Shun, PhD
  • Telefonní číslo: +886911268998
  • E-mail: scshun@nycu.edu.tw

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Inclusion Criteria:

  1. age ≥18 years
  2. diagnosed as AGC (TNM: T2~T4, N>0, Any M, Stage: III~IV, or unresectable GC)
  3. scheduled to receive the first cycle of immunotherapy
  4. willingness to provide written informed consent after receiving a full explanation of the study

Exclusion Criteria:

  1. a diagnosis of another type of cancer within the past five years
  2. inability to communicate clearly
  3. a diagnosis of dementia
  4. acute pulmonary embolism
  5. acute myocardial infarction
  6. extremity bone fracture within the past three months
  7. bone metastasis

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Jiný
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Singl

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Intervention
AI-ISME&HE intervention group
  • Self-reporting treatment-related adverse events
  • Interacting with AI-ISME&HE for seeking information related to self-management educational materials, including symptom management with the most reported trAEs and prevention from frailty
  • ViviFrail-based exercise
Žádný zásah: Control
Usual routine care

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Level of Frailty Assessed by The Short Physical Performance Battery (SPPB)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The SPPB score from 0-12 points, with 10-12 indicating robust, 7-9 indicating prefrail, and 4-6 indicating frail. It has good reliability (ICC range from 0.82-0.92) and validity.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Frailty Assessed by Comprehensive Geriatrics Assessment
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.

A total of 8 domains were used to comprehensively assess frailty in cancer patients: Functional status, Comorbidity, Nutrition, Polypharmacy, Social support, Cognition, and Mood. 0 abnormal domains indicate robust, any 1 abnormal indicates pre-frail, and 2 or more abnormality indicate frailty. Each domain can be assessed by different tools. In this study, we chose the tools according as follows:

  1. Functional status: Grip strength.
  2. Comorbidity: Charlson Comorbidity Index by ICD-10 and exclude age and cancer diagnosis. CCI scores > 3 indicates multimorbidity.
  3. Cognition: the Montreal Cognitive Assessment (MoCA).
  4. Mood: Geriatric Patient Health Questionnaire-9 (PHQ-9).
  5. Nutritional status: Mini Nutritional Assessment (MNA).
  6. Polypharmacy: number of daily medications.
  7. Social support: live alone or with family.
  8. Falls history: the falling times in the past year.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Frailty Assessed by Geriatric 8 (G8)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The G8 score from 0-17 points, with score ≤14 indicating frailty. It has good sensitivity (86.9%) in cancer patients
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Frailty Assessed by Taiwan Cancer Frailty Tool (TCFT)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The TCFT score from 0-5 points, with score >0 indicating frailty. It has good ROC values of 0.857 in cancer patients
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Score of Quality of Life Assessed by The Functional Assessment of Cancer Therapy - General - 7 Item Version (FACT-G7)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
It includes 7 items and compromised physical well-being (3 items), emotional well-being (1 items), and functional well-being (3 items). The score of each item is from 0 (not at all) to 5 (very much), and the total score ranging from 0 to 28, with a higher score indicating better quality of life.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Self-efficacy Assessed by The Modified Cancer Behavior Inventory (CBI)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
It is a 0-10 Likert-type scale, where 0 indicates no confidence at all and 10 indicates fully confidence.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
All Cause Mortality After 2 Year Follow-up
Časové okno: Record patient's survival status at baseline, 1 year after baseline, and 2 year after baseline.
The survival status of the patients will be followed by medical record.
Record patient's survival status at baseline, 1 year after baseline, and 2 year after baseline.
Level of Symptom Severity Assessed by The Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The 14 symptoms include fatigue, headache, shortness of breath, nausea/vomiting, rash, diarrhea, decreased appetite, numbness/tingling, general pain, blurred vision, constipation, abdominal pain, itching, and dizziness. Symptoms are assessed by using five-point Likert-type scale to rate symptom frequency (never, rarely, occasionally, frequently, almost constantly), severity (none, mild, moderate, severe, very severe), and interference (not at all, a little bit, somewhat, quite a bit, very much) in the past 7 days. It can composite grading based on an algorithm into grade 0 to 3.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Nutrition Status Assessed by The Mini Nutritional Assessment Short Form (MNA-SF)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
It includes 6 items relating to food intake in the past three months, weight loss in the past three months, physical activity, stress, dementia or depression, and body mass index (BMI). The total score ranges from 0-14, with 12-14 representing well, 8-11 representing at risk, and 0-7 representing malnutrition.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Cognitive Function Assessed by The Montreal Cognitive Assessment (MoCA)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The scale consists of 12 items with a total score ranging from 0 to 30, assessing cognitive function across eight domains, including visuospatial construction, executive function, naming, memory, attention, language, abstraction, delayed recall, and orientation. A score of 24 below indicates cognitive impairment.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Depression Assessed by The Patient Health Questionnaire-9 (PHQ-9)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
PHQ-9 is a depression muddle from the complete PHQ, including nine DSM-IV criteria for depression, each item scores from 0-3, with a total score range from 0-27. A higher score indicates higher severity of depression, with a score 0-4 as none, 5-9 as mild, and ≥ 10 as moderate-severe depression.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Physical Function Assessed by Grip Strength (GS)
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
GS will be assessed by JAMAR hydraulic dynamometer, which show good reliability. The participants will be asked to sit in the neutral position with their elbows flexed at 90° and resting at their sides. Next, they need to squeeze the handle of the dynamometer for 3-5 seconds as hard as possible for 3 trials on dominant hand with a rest of 60 seconds. The average and the maximum of the grip strength (kg) will be recorded. Female with GS ≤ 16 kg and male ≤ 26.7 kg refer to frailty.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Changes of Body Composition Assessed by Body Composition Machine
Časové okno: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Body composition will be examined by ACCUNIQ BC300 which is a lightweight, foldable professional body composition analyzer that utilizes bioelectrical impedance analysis (BIA) technology. Through eight electrodes and three different frequencies (5, 50, 250 kHz), it performs full-body and segmented (arms, legs, torso) measurements, quickly providing detailed data such as body fat, muscle mass, and water content with high accuracy within 5 minutes.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Spolupracovníci

Vyšetřovatelé

  • Studijní židle: I-Wen Chang, PhD, Department of Nursing, Taipei Veterans General Hospital

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

21. července 2026

Primární dokončení (Odhadovaný)

31. července 2029

Dokončení studie (Odhadovaný)

31. července 2030

Termíny zápisu do studia

První předloženo

23. července 2026

První předloženo, které splnilo kritéria kontroly kvality

23. července 2026

První zveřejněno (Aktuální)

29. července 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

29. července 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

23. července 2026

Naposledy ověřeno

1. července 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • 2026-02-009CC
  • 115-2314-B-A49 -016 -MY3 (Jiné číslo grantu/financování: National Science and Technology Council)

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .