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HOPE - A Study to Evaluate the Effect of a Prehabilitation Program on GI Cancer Patients Planning to Undergo Surgery (HOPE)

7. september 2018 opdateret af: Siobhan Trotter

H.O.P.E. Healing Optimization Through Preoperative Engagement: A Prospective Single Cohort Study to Evaluate the Effect of a Prehabilitation Program on Preoperative Outcomes in Upper GI Surgical Oncology Patients

A one-group prospective cohort study design with measures collected pre- and post-intervention. The primary goal of this study is to evaluate the effect of a multimodal prehabilitation preoperative program on changes in frailty in upper gastrointestinal surgical oncology patients.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Cancer patients often develop protein calorie malnutrition, inflammatory states, and loss of lean muscle mass, which can be best categorized as frailty. Frailty affects global health, the ability to carry out normal functions, and even the ability to tolerate targeted curative treatments such as surgery, chemotherapy, and radiation. The Investigators evaluate frailty, and design a study to evaluate the outcomes of the administration of multimodal preoperative prehabilitation programs on those frailty markers. Previous data provides support for interventions that include:

  1. Improved protein rich nutrition with specific immunonutrition recommendations,
  2. Treatment of maldigestion or pancreatic insufficiency in pancreatic, gastric, or esophageal cancer patients,
  3. Brief, evidence-based activity interventions such as walking and inspiratory muscle training (IMT), and
  4. Disease specific education

These interventions should improve frailty by maintaining or regaining weight, improved grip strength, and improved prealbumin. These markers indicate improvements in nutritional status, increased strength and ability to ambulate, and improved functional status in the preoperative period. Other outcomes that will be reported include fat-soluble vitamin levels, global health, and inflammation.

The preoperative period is the best time to facilitate patient engagement through self-care and proactive activity. Interventions must be easy to accomplish and structured so patients have accountability and both patients and clinicians have methods and tools for measuring progress. Most patients and family members are motivated at this time and understand the need to improve frailty and potentially improve global health.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

60

Fase

  • Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Louisiana
      • New Orleans, Louisiana, Forenede Stater, 70471
        • Ochsner Medical Center

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

25 år til 80 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • All patients must be patients of Ochsner being seen at the Ochsner Medical Center (OMC).
  • All patients must be 25 to 80 years of age.
  • All patients must have a diagnosis of cancer.
  • > 10 pound unintentional weight loss within 1 year
  • Ability to perform grip strength test and Timed Up and Go (TUG) test
  • Willingness to participate in the study, document compliance, and attend clinical appointments

  • All patients must be undergoing one of the following major elective surgical oncologic resections with curative intent:

    • Pancreaticoduodenectomy for pancreatic cancer
    • Distal pancreatectomy / splenectomy for pancreatic cancer
    • Esophageal robotic assisted laparoscopic thoracoscopic esophagectomy for esophageal cancer
    • Laparoscopic or open, partial or total gastrectomy for gastric cancer

Exclusion Criteria:

  • All patients not undergoing oncologic or major resections.
  • All patients unwilling or unable to answer questionnaires or accept help to answer electronic or paper questionnaires.
  • All patients that are unable to participate in an activity program.
  • All patients unable to wear an electronic activity monitoring device.
  • All patients not wanting to follow a specific nutritional and breathing intervention.
  • All patients that are not able or wishing to consent.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Frail
Subjects assessed and determined to be Frail and meet trial eligibility criteria will be enrolled on Frail Arm and begin a 4 Week program consisting of Nutritional Interventions and Physical Activity Interventions
Kombinationsprodukt: Nutritional Intervention
Nutritional Supplementation for all subjects and Pancreatic Enzyme Replacement Therapy only for subjects with Exocrine Pancreatic Insufficiency
Andre navne:
  • Immunonutrition
Adfærdsmæssigt: Physical Activity Intervention
Walking and Inspiratory Muscle Training
Aktiv komparator: Not Frail
Subjects assessed and determined to be Not Frail and meet trial eligibility criteria will be enrolled on Not Frail Arm and begin a 4 Week program consisting of Nutritional Interventions and Physical Activity Interventions
Kombinationsprodukt: Nutritional Intervention
Nutritional Supplementation for all subjects and Pancreatic Enzyme Replacement Therapy only for subjects with Exocrine Pancreatic Insufficiency
Andre navne:
  • Immunonutrition
Adfærdsmæssigt: Physical Activity Intervention
Walking and Inspiratory Muscle Training

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Frailty Measurement
Tidsramme: 4 Weeks
Frailty will be measured using 3 criteria: weight loss, grip strength, and prealbumin serum level
4 Weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Vitamin levels
Tidsramme: 4 Weeks
4 Weeks
Quality of Life (QoL) Assessment
Tidsramme: 4 Weeks
QoL will be assessed using Patient-Reported Outcome Measurement Information System (PROMIS) Global Health Questionnaire - PROMIS Scale v1.2 - Global Health
4 Weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Siobhan Trotter

Efterforskere

  • Ledende efterforsker: Siobhan M Trotter, DNP, Ochsner Health System

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 (Faktiske)

1. august 2018

Primær færdiggørelse (Forventet)

1. december 2018

Studieafslutning (Forventet)

1. maj 2019

Datoer for studieregistrering

Først indsendt

20. juni 2018

Først indsendt, der opfyldte QC-kriterier

20. august 2018

Først opslået (Faktiske)

22. august 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

11. september 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

7. september 2018

Sidst verificeret

1. september 2018

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • HOPE Study 2018.045

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

produkt fremstillet i og eksporteret fra U.S.A.

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Mavekræft

Kliniske forsøg med Nutritional Intervention

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Sponsorer og samarbejdspartnere

Medicinske tilstande

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Betingelser

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Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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