- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07777471
Improving Delivery of Aging-Related Supportive Care for Older Adults With Acute Myeloid Leukemia (ACTIVE DEFAULT)
Active Default Pilot: Implementation of Geriatric Assessment-Driven Supportive Care for Older Adults With Acute Myeloid Leukemia Receiving Venetoclax-Based Therapy
The goal of this clinical trial is to test a way of delivering supportive care to adults 60 years and older who are starting venetoclax-based treatment for newly diagnosed acute myeloid leukemia (AML). Older adults with AML often have aging-related needs, such as problems with mobility, nutrition, mood, memory, or medications, that are not always addressed in a consistent way. In this study, a health questionnaire and short in-person checks (a geriatric assessment) are used to find these needs early, and matching supportive care orders are prepared in the electronic health record and sent to the treating doctor, who decides whether to place each one. This approach is called Active Default. The main questions the study aims to answer are:
- How often are the prepared supportive care orders signed by treating doctors (implementation fidelity)?
- Can each step of the process, from completing the assessment to receiving supportive care services, be carried out as planned?
Participants will:
- Complete questionnaires and short in-person checks of walking, balance, strength, memory, mood, and medications at the start of treatment
- Receive supportive care services (for example physical therapy, nutrition, or social work) if their doctor approves the prepared orders
- Answer phone check-ins over 90 days and repeat two short checks at about two months
- Be invited to one optional interview about their experience
Healthcare providers involved in participants' care will be invited to complete a one-time survey and an optional interview about the approach.
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Aditi Sharma, MD
- Telefonní číslo: 205-975-0412
- E-mail: adshar@uabmc.edu
Studijní místa
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Alabama
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Birmingham, Alabama, Spojené státy, 35233
- University of Alabama at Birmingham
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Dílčí vyšetřovatel:
- Nicole Henderson, PhD
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Kontakt:
- Aditi Sharma, MD
- Telefonní číslo: 205-975-0412
- E-mail: adshar@uabmc.edu
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Vrchní vyšetřovatel:
- Aditi Sharma, MD
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Dílčí vyšetřovatel:
- Gabrielle Rocque, MD, MSPH
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Dílčí vyšetřovatel:
- Smita Bhatia, MD, MPH
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Dílčí vyšetřovatel:
- Pankit Vachhani, MD
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Dílčí vyšetřovatel:
- Andres Azuero, PhD, MBA
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
Patient participants:
- Age 60 years or older
- Newly diagnosed acute myeloid leukemia (AML), including de novo, secondary, or therapy-related AML, per current World Health Organization (WHO) or International Consensus Classification (ICC) classification
- Planned for first-line venetoclax-based lower-intensity therapy
- English-speaking
- Able to provide informed consent personally or through a Legally Authorized Representative (LAR)
Provider participants:
-Participating leukemia attending physicians and supportive care service leads involved in the care of enrolled participants
Exclusion Criteria:
Patient participants:
- Acute promyelocytic leukemia
- Planned intensive induction or non-venetoclax-based therapy
- Life expectancy under 14 days or hospice enrollment at screening
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Výzkum zdravotnických služeb
- Přidělení: N/A
- Intervenční model: Přiřazení jedné skupiny
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
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Experimentální: Active Default
Patients aged 60 and older with newly diagnosed AML starting venetoclax-based therapy (n=25) receive the Active Default intervention: a geriatric assessment at the start of treatment, with results crossing pre-specified thresholds generating matched supportive care orders that are prepared in the electronic health record and sent to the treating physician to approve or decline.
Patients are followed for 90 days, with phone check-ins and repeat physical function and cognition checks at about 60 days.
Healthcare providers involved in enrolled patients' care (up to 15) complete a one-time survey and are invited to an optional interview about the approach.
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An electronic health record-based order-queuing mechanism that delivers geriatric assessment-driven supportive care.
A structured geriatric assessment is completed at the start of venetoclax-based therapy.
Results crossing pre-specified thresholds trigger matched supportive care orders (for example physical therapy, nutrition, social work, pharmacy medication review, geriatrics, mental health, chaplaincy), which the study team prepares as proposed orders for the treating physician to approve or decline.
The supportive care services themselves are standard of care; the intervention modifies only the order-entry workflow.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Proportion of eligible triggered supportive care orders signed by the treating physician within 7 days (implementation fidelity)
Časové okno: Within 7 days of each supportive care order placement; orders are placed after the baseline geriatric assessment and within 7 days before or after Cycle 1 Day 1 of venetoclax-based therapy (each cycle is 28 days)
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Measured as the number of eligible geriatric assessment-triggered supportive care orders signed by the treating physician within 7 days of order placement, divided by the total number of eligible triggered orders, using electronic health record order data.
Eligible triggers are those not already engaged in the corresponding service or pre-declined by the patient at the pre-referral screen.
Reported as a point estimate with 95% Clopper-Pearson confidence interval.
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Within 7 days of each supportive care order placement; orders are placed after the baseline geriatric assessment and within 7 days before or after Cycle 1 Day 1 of venetoclax-based therapy (each cycle is 28 days)
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Proportion of signed supportive care orders with at least one completed service visit (service engagement)
Časové okno: 90 days from Cycle 1 Day 1, the first day of venetoclax-based therapy (each cycle is 28 days)
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Measured as the number of signed supportive care orders with at least one completed visit in the corresponding service within 90 days of Cycle 1 Day 1, divided by the total number of signed orders, using electronic health record data.
Reported as a point estimate with 95% Clopper-Pearson confidence interval.
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90 days from Cycle 1 Day 1, the first day of venetoclax-based therapy (each cycle is 28 days)
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Spolupracovníci a vyšetřovatelé
Vyšetřovatelé
- Vrchní vyšetřovatel: Aditi Sharma, MD, University of Alabama at Birmingham
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
Další identifikační čísla studie
- IRB-300016966
- UAB (Jiný identifikátor: UAB)
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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