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Improving the Quality of Life of Cancer Patients Through a Perioperative and Coordinated Nutrition and Physical Care Program. (PENDICOQ)

10. september 2021 opdateret af: University Hospital, Strasbourg, France

Hospitalization, for cancer patients, exposes to a risk of undernutrition which has the effect of significantly increasing infections, pressure ulcers, muscle wasting, loss of autonomy, impaired function and delayed healing.

All of these factors contribute to increase the length of stay in hospital, thus lengthening the spiral of undernutrition, which has serious consequences for the patient welbeing, health establishments and public health.

Undernutrition has been the subject of many studies over the last twenty years, that outline that an adequate nutritional management exerts a direct effect on the reduction of comorbidities and duration of hospitalization.

However, there are periods, in the preoperative course of care, where nutritional and phisical care are not realized in the current clinical practice whereas they could be done, for example, between the diagnosis and the consultation of anesthesia, between the anesthesia consultation and the surgical procedure and the end of hospitalization of the patient.

Current management is usually limited to the period of hospitalization which tends to be reduced. This situation is reinforced by the absence of relays at home, dietary consultations being not reimbursed by French health insurance.

Moreover, a preliminary survey, conducted in 2012 during the pre-operative outpatient anesthesia consultation, shows that 26% of patients are already clinically malnourished, with 16.5 % of them who have lost more than 10% of their weight.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Then, the investigators hypothesize that the combination of perioperative nutrition and mobilization program coordinated andrealized by dieticians and physiotherapists, with the Nutrimus follow-up booklet, would improve the post-operative evolution of patients and reduce their postoperative comorbidities.

This management, initiated at the consultation of anesthesia, would include an accurate nutritional diagnosis, nutritional and physical support therapy to improve their nutritional and muscular status.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

200

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiekontakt

Studiesteder

  • Frankrig
      • Strasbourg, Frankrig, 67098
        • Rekruttering
        • Service de Médecine Interne et Nutrition, Hôpital de Hautepierre, Hôpitaux universitaires de Strasbourg
        • Ledende efterforsker:
          • Alain Pradignac, MD
        • Kontakt:
        • Kontakt:

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:

  • Patient ≥ 18 years old
  • Patient with Karnofsky index superior or equal to 60%.
  • Patient with cancer of the following digestive tract: peritoneal carcinoma, sarcoma, pancreas, rectum, esophagus, stomach diagnosed or under diagnosis
  • Patient admitted for a scheduled surgery at least 10 days after a preoperative consultation
  • Patient affiliated to a social health insurance scheme
  • Patient having dated and signed an informed consent
  • Patient having been informed of the results of the prior medical examination

Exclusion Criteria:

  • Inhospital patients
  • Patient admitted in emergency
  • Impossibility of giving the patient information (alteration of patient's cognitive function)
  • Illiteracy or dyscalculia
  • Patients protected (guardianship, curatorship, safeguard of justice)
  • Pregnancy, breastfeeding
  • Subject in exclusion period (determined by a previous or ongoing study),
  • Patient included in another ongoing clinical trial
  • Patient with neuro-endocrine cancer
  • Patient reoperated for the same pathology

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Experimental group
nutritional and functional management coordinated by dieticians and physiotherapists, with adapted nutritional and physical advice and support, realized with the use of Nutrimus booklet in order to facilitate coordination and delivration of cares proposed to the patients
Andet: Dietary intervention
Nutritional status assessment Presentation of the Nutrimus booklet by the coordinating dietitian Establishment or adaptation of a nutritional support (prescription of nutritional supplements if necessary). Delivery and explanation of the preoperative nutritional counseling support
Andet: Intensify physiotherapist intervention
Respiratory capacity Functional capacity Tips adapted for physical activity and strengthening or maintenance of muscle mass Presentation of respiratory physiotherapy exercises to prevent postoperative bronchial congestion Nutrition and physical mobilization tips with the Nutrimus booklet
Aktiv komparator: Control group
usual preoperative advice for patients who undergoing surgical procedure concerning nutritional cares and physical activity
Andet: Dietary advice
Nutritional status assessment Explanation of standard nutritional advices with an written explanation sheet
Andet: Physiotherapist intervention
Respiratory capacity Functional capacity

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Variation of the Medical Outcome Study Short Form 36 score
Tidsramme: Change in score at 30 days before surgery and 1 Day before hospital discharge
Use of a scale for quality of life
Change in score at 30 days before surgery and 1 Day before hospital discharge

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Sarcopenia index measurement
Tidsramme: 30 days before surgery
Measure from routine preoperative Computerized Tomography scan
30 days before surgery
Satisfaction score of the Nutrimus tool
Tidsramme: 6 months postoperative
Use of a questionnaire
6 months postoperative
Ease of use of the Nutrimus tool
Tidsramme: 6 months postoperative
Use of a questionnaire
6 months postoperative
Measurement of the Medical Outcome Study Short Form 36 score
Tidsramme: Change in score at 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Use of a scale for quality of life
Change in score at 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Evaluation of nutritional parameters
Tidsramme: Change in values measures at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Use of a notebook
Change in values measures at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Evaluation of respiratory and functional capacities
Tidsramme: Change in measures at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Change in measures at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Pain assessment
Tidsramme: Change in score at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Use of a visual analogue scale Measure of score from 0 to 10
Change in score at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Length hospitalization
Tidsramme: Duration (in days) of patient's hospitalization
Length (in days) between hospital admission and discharge
Duration (in days) of patient's hospitalization

Samarbejdspartnere og efterforskere

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

Sponsor

University Hospital, Strasbourg, France

Efterforskere

  • Ledende efterforsker: Alain PARDIGNAC, Strasbourg Universitary hospitals

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)

29. januar 2019

Primær færdiggørelse (Forventet)

28. april 2024

Studieafslutning (Forventet)

28. april 2024

Datoer for studieregistrering

Først indsendt

11. juli 2018

Først indsendt, der opfyldte QC-kriterier

12. september 2018

Først opslået (Faktiske)

13. september 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. september 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. september 2021

Sidst verificeret

1. september 2021

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 6117

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

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