- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00313573
Telemedicine or Standard Care in Treating Patients With Depression and/or Pain Caused By Cancer
TeleCare Management of Pain and Depression in Cancer
RATIONALE: Telemedicine may help in the treatment of depression and/or pain caused by cancer. It is not yet known whether telemedicine is more effective than standard care in treating depression and/or pain caused by cancer.
PURPOSE: This phase III randomized clinical trial is studying telemedicine to see how well it works compared to standard care in treating patients with depression and/or pain caused by cancer.
Studieoversigt
Status
Detaljeret beskrivelse
OBJECTIVES:
Primary
- Compare the effectiveness of a state-wide, telemedicine intervention with standard care in cancer patients with clinical depression and/or cancer-related pain.
- Compare improvement in clinical depression and/or cancer-related pain in patients undergoing these interventions.
Secondary
- Compare health-related quality of life, functional status, and patient satisfaction with treatment in patients undergoing these interventions.
- Compare the economic benefits of these interventions in these patients.
OUTLINE: This is a randomized, longitudinal, multicenter study. Patients are stratified according to study site and type of symptom (pain only vs depression only vs pain and depression). Patients are randomized to 1 of 2 treatment arms.
- Arm I (standard care): Patients receive treatment for pain, depression, and other symptoms from their oncologist.
- Arm II (telemedicine intervention): Patients undergo automated, home-based symptom monitoring either by telephone or the Internet, depending on preference, coupled with telephonic care management by a clinical specialist. Patients complete questionnaires via the Internet or undergo standardized interviews via telephone measuring depression, pain, quality of life, and other patient-reported variables twice weekly for approximately 1 month, once weekly for 2 months, twice a month for 3 months, and then once a month for 6 months. A clinical specialist trained in treating the symptoms of pain and depression also contacts the patient by phone to assess symptom severity and initiate treatment. A follow-up call is made at 1-2 weeks to assess symptom severity, adherence, and adverse effects. Patients with depression receive 2 additional follow-up calls in the first 12 weeks. The clinical specialist also calls the patient when automated monitoring indicates inadequate symptom improvement or side effects, or the patient requests to be contacted. The clinical specialist works with the patient's regular doctor in adjusting medicines and treatment for symptoms as needed. Patients who do not complete their scheduled assessments receive an automated call or e-mail message reminding them to complete the symptoms questionnaires. Patients who do not respond to this reminder within 24 hours are contacted by the clinical specialist.
In both arms, patients are interviewed at baseline, 1, 3, 6, and 12 months. Patients are asked questions about pain, depression, other physical and emotional symptoms, work activities, quality of life, and satisfaction with treatment.
PROJECTED ACCRUAL: A total of 480 patients will be accrued for this study.
Undersøgelsestype
Tilmelding (Forventet)
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
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Indiana
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Anderson, Indiana, Forenede Stater, 46011
- Community Cancer Center at Community Hospital of Anderson
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Bedford, Indiana, Forenede Stater, 47421
- Community Cancer Care at Bedford Oncology Specialty Clinic
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Columbus, Indiana, Forenede Stater, 47201
- Columbus Regional Hospital Cancer Center
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Greencastle, Indiana, Forenede Stater, 46135
- Community Cancer Care at Putnam County Hospital
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Greensburg, Indiana, Forenede Stater, 47240
- Community Cancer Care at Decatur County Hospital
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Indianapolis, Indiana, Forenede Stater, 46202
- William N. Wishard Memorial Hospital
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Indianapolis, Indiana, Forenede Stater, 46206-1367
- Methodist Cancer Center at Methodist Hospital
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Indianapolis, Indiana, Forenede Stater, 46219
- Community Regional Cancer Care at Community Hospital East
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Indianapolis, Indiana, Forenede Stater, 46256
- Community Regional Cancer Care at Community Hospital North
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Indianapolis, Indiana, Forenede Stater, 46202
- Veterans Affairs Medical Center - Indianapolis
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Indianapolis, Indiana, Forenede Stater, 46202-2872
- Regenstrief Institute, Incorporated
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Indianapolis, Indiana, Forenede Stater, 46202
- Community Cancer Care
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Kokomo, Indiana, Forenede Stater, 46902
- Community Cancer Care at Howard Regional Health System
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Madison, Indiana, Forenede Stater, 47250
- Community Cancer Care at King's Daughters' Hospital
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Seymour, Indiana, Forenede Stater, 47274
- Schneck Medical Center
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Tell City, Indiana, Forenede Stater, 47586
- Community Cancer Care at Perry County Hospital
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Tipton, Indiana, Forenede Stater, 46072
- Community Cancer Care at Tipton County Memorial Hospital
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
DISEASE CHARACTERISTICS:
Diagnosis of cancer AND 1 or both of the following:
Clinical depression
Depression must be of at least moderate severity (PHQ-9 score ≥ 10)
- Depressed mood and/or anhedonia endorsed
- No depression directly precipitated by cancer therapy for which depression is a well known side effect (e.g., interferon, corticosteroids)
Cancer-related pain
- Pain must be at least moderate in severity (Brief Pain Inventory score ≥ 6), persisted despite using ≥ 2 analgesics, and cancer-related
- If the only pain is due to a pre-existing condition (e.g., migraine, headache, arthritis, etc), the patient may not be eligible
PATIENT CHARACTERISTICS:
- Life expectancy ≥ 6 months
- Must speak English
- Not pregnant
- Fertile patients must use effective contraception
- No moderately severe cognitive impairment
- No schizophrenia or other psychosis
- No disability claim currently being adjudicated for pain
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Not in hospice care
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Tildeling: Randomiseret
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
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Compare efficacy of 3-component model telemedicine intervention to standard care in terms of depression and pain at baseline and 1, 3, 6, and 12 months
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Sekundære resultatmål
Resultatmål |
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Health-related quality of life at baseline and 1, 3, 6, and 12 months
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Cost-effectiveness of care at baseline and 1, 3, 6, and 12 months
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Treatment satisfaction at baseline and 1, 3, 6, and 12 months
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Samarbejdspartnere og efterforskere
Samarbejdspartnere
Efterforskere
- Studiestol: Kurt Kroenke, MD, Regenstrief Institute, Incorporated
Publikationer og nyttige links
Generelle publikationer
- Dube P, Kurt K, Bair MJ, Theobald D, Williams LS. The p4 screener: evaluation of a brief measure for assessing potential suicide risk in 2 randomized effectiveness trials of primary care and oncology patients. Prim Care Companion J Clin Psychiatry. 2010;12(6):PCC.10m00978. doi: 10.4088/PCC.10m00978blu.
- Kroenke K, Wu J, Yu Z, Bair MJ, Kean J, Stump T, Monahan PO. Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials. Psychosom Med. 2016 Jul-Aug;78(6):716-27. doi: 10.1097/PSY.0000000000000322.
- Brown LF, Kroenke K, Theobald DE, Wu J, Tu W. The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain. Psychooncology. 2010 Jul;19(7):734-41. doi: 10.1002/pon.1627.
- Kroenke K, Theobald D, Wu J, Norton K, Morrison G, Carpenter J, Tu W. Effect of telecare management on pain and depression in patients with cancer: a randomized trial. JAMA. 2010 Jul 14;304(2):163-71. doi: 10.1001/jama.2010.944.
- Kroenke K, Zhong X, Theobald D, Wu J, Tu W, Carpenter JS. Somatic symptoms in patients with cancer experiencing pain or depression: prevalence, disability, and health care use. Arch Intern Med. 2010 Oct 11;170(18):1686-94. doi: 10.1001/archinternmed.2010.337.
- Cohee AA, Kroenke K, Vachon E, Wu J, Tu W, Johns SA. Predictors of depression outcomes in adults with cancer: A 12 month longitudinal study. J Psychosom Res. 2020 Sep;136:110169. doi: 10.1016/j.jpsychores.2020.110169. Epub 2020 Jun 11.
- Choi Yoo SJ, Nyman JA, Cheville AL, Kroenke K. Cost effectiveness of telecare management for pain and depression in patients with cancer: results from a randomized trial. Gen Hosp Psychiatry. 2014 Nov-Dec;36(6):599-606. doi: 10.1016/j.genhosppsych.2014.07.004. Epub 2014 Jul 19.
- Hayano J, Carney RM, Watanabe E, Kawai K, Kodama I, Stein PK, Watkins LL, Freedland KE, Blumenthal JA. Interactive associations of depression and sleep apnea with adverse clinical outcomes after acute myocardial infarction. Psychosom Med. 2012 Oct;74(8):832-9. doi: 10.1097/PSY.0b013e31826d2c81. Epub 2012 Sep 28.
- Wang HL, Kroenke K, Wu J, Tu W, Theobald D, Rawl SM. Predictors of cancer-related pain improvement over time. Psychosom Med. 2012 Jul-Aug;74(6):642-7. doi: 10.1097/PSY.0b013e3182590904. Epub 2012 Jun 28.
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Forventet)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- CDR0000466348
- IUMC-051009
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