Cancer & Chemotherapy Symptom Management Using an Automated Telephone Reporting System
28. februar 2017 opdateret af: Kathleen Mooney, University of Utah
Telephone Linked Care for Cancer Symptom Management
The purpose of this study was to test the efficacy of a computer-based automated symptom monitoring telephone system used by patients who received chemotherapy for their cancer to communicate unrelieved symptoms they experienced to their oncology providers.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
The purpose of this study was to test the efficacy of a computer-based automated symptom monitoring telephone system used by patients who received chemotherapy for their cancer to communicate unrelieved symptoms they experienced to their oncology providers.
The symptoms monitored in the project were nausea/vomiting, pain, sore mouth, diarrhea, constipation, depressed mood, anxiety, trouble sleeping, and fatigue.
The study randomly assigned participants into either the intervention group or the group that received usual care from their oncology providers without alert notifications.
All participants called the automated system daily to report their symptom presence, severity, and distress.
When participants in the intervention group rated symptoms at moderate (4-7) to severe (8-10) levels an e-mail alert report of their symptom information was sent to the participant's medical oncologist and oncology nurse.
The usual care group also reported symptoms daily to the automated system but their information was not sent to the providers.
Participants in the usual care group were told daily to call their oncology provider if they had concerns about their symptoms.
The two study groups were compared over chemotherapy cycles 2 and 3 on symptom presence, severity, and distress.
Functional status, patient reported degree of symptom interference with normal activities, and work attendance if they had indicated that they worked during their treatment were also recorded.
In addition, the groups were compared for the number and purpose of unscheduled patient-provider contacts, visits to the emergency department or urgent care facility, and unscheduled hospitalizations.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
250
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02118
- Boston Medical Center
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South Carolina
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Greer, South Carolina, Forenede Stater, 29650
- South Carolina Community Oncology Practice
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Utah
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Salt Lake City, Utah, Forenede Stater, 84112
- University of Utah Huntsman Cancer Institute
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
18 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Adult (18 or older)
- Histological Diagnosis of Cancer
- Life Expectancy of at least 6 months
- Cognitively able to participate (verified by provider team)
- Initiated a course of new Chemotherapy that is planned for a minimum of 3 cycles
- Had Poorly controlled symptoms during the first cycle of chemotherapy
- Care under the direction of one of the designated provider teams
- English or Spanish speaking
- Has access to a telephone on a daily basis
- Able to use the telephone unassisted
Exclusion Criteria:
- Receiving concurrent radiation therapy because they would be in daily contact with oncology care providers.
- Patients seeing the provider team for recommendation of chemotherapy regimen but other providers then administer treatment at different site
- Patients receiving a treatment regimen with only biotherapy agents or agents not associated with the symptoms monitored
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Støttende pleje
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Eksperimentel: Provider Unrelieved Symptom Alert
Patients in the intervention arm called the automated monitoring system daily to report presence, severity and distress on a 1-10 scale for nine symptoms.
The system immediately sent an emailed symptom alert report to their oncologist and oncology nurse if symptoms exceeded preset thresholds (moderate to severe levels).
Two thresholds were set: a simple alert when severity or distress was 4 or greater on the 10 point scale and trend alerts based on a pattern of moderate severity over several days.
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The Provider Unrelieved Symptom Alert intervention sent an automatic symptom report to oncology providers (both physician and nurse) when the patient reported symptoms at a moderate to severe level (4-10 on a 0-10 scale).
The oncology providers used their clinical judgement in terms of what they did with the information received.
There was no prescribed response as part of the intervention.
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Ingen indgriben: Attentional Control Usual Care Group
Patients in the usual care group called the automated monitoring system daily to report presence, severity and distress (1-10 scale) on 9 symptoms and also measured symptom interference with daily activities, functional status, work attendance, and unscheduled provider visits, urgent care and emergency department visits, and unscheduled hospitalizations.
The usual care group received equivalent contact time with the automated system including identical voice and assessment questions.
Data were not available for clinical action and not reported to the oncology providers.
On every call, usual care participants were reminded to call their oncology provider if they had symptom concerns, which is the usual practice in oncology settings to address unrelieved symptoms.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Patient reported symptom levels on a 0-10 scale
Tidsramme: patients report symptoms daily for the duration of the study, an expected average of 6 weeks
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During daily automated calls, patients provided information about common chemotherapy symptoms.
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patients report symptoms daily for the duration of the study, an expected average of 6 weeks
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Medical Encounters Telephone Interview
Tidsramme: participants will be followed for an expected average of 6 weeks
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When a patient reports during their daily phone call with the automated symptom monitoring system that they had been in contact with a health care provider, the research staff would conduct a short telephone interview to collect data about the nature of the medical encounter including whether the medical encounter was related to the symptoms being monitored by the system.
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participants will be followed for an expected average of 6 weeks
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Functional Status
Tidsramme: monthly for the duration of the study, participants will be followed for an expected average of 6 weeks
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The SF-12 was administered monthly to measure functional status.
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monthly for the duration of the study, participants will be followed for an expected average of 6 weeks
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Work Attendance
Tidsramme: reported daily, participants will be followed for an expected average of 6 weeks
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Patients who indicated at study enrollment that they planned to work during treatment answered a yes/no question during the automated symptom monitoring system call to report whether or not they worked the previous day.
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reported daily, participants will be followed for an expected average of 6 weeks
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Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Patient End of Study Telephone Interview
Tidsramme: administered at the end of participation in the study, participants will be followed for an expected average of 6 weeks
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An End of Study Telephone Interview was conducted at the end of a patient's participation in the project to obtain data on patient satisfaction with the symptom monitoring system and to obtain suggestions for improvement of the system.
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administered at the end of participation in the study, participants will be followed for an expected average of 6 weeks
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Provider End of Study Interview
Tidsramme: Once, at the end of participation which is an expected average of 24 months
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At the end of the study, participating providers were interviewed regarding the acceptability and use of the symptom alert reports and their suggestions for improvement.
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Once, at the end of participation which is an expected average of 24 months
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Kathleen H Mooney, PhD, University of Utah
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. april 2001
Primær færdiggørelse (Faktiske)
1. marts 2004
Studieafslutning (Faktiske)
1. marts 2004
Datoer for studieregistrering
Først indsendt
22. oktober 2013
Først indsendt, der opfyldte QC-kriterier
1. november 2013
Først opslået (Skøn)
8. november 2013
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
1. marts 2017
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
28. februar 2017
Sidst verificeret
1. februar 2017
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Andre undersøgelses-id-numre
- 7846-00
- R01CA089474 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
INGEN
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