Integrating Supportive Care in Cystic Fibrosis
17 de febrero de 2020 actualizado por: Dio Kavalieratos, PhD, University of Pittsburgh
Integrating Supportive Care in Cystic Fibrosis: A Pilot Study
Individuals living with cystic fibrosis (CF) commonly report high symptom burden, poor quality of life, and additional psychosocial stressors; these burdens are particularly heightened in advanced stages of the disease.
Although supportive care (aka palliative care) has been shown to improve many of these outcomes among patients with illnesses such as cancer, no clinical trials to date have tested the impact of supportive care for patients with CF.
The purpose of this pilot randomized clinical trial study is to evaluate the feasibility, acceptability, and perceived effectiveness of an embedded supportive care intervention, whereby a supportive care specialist will be integrated within the usual care experience of patients with advanced CF.
The investigators will enroll 50 patients with advanced CF, who will be equally randomized to receive this embedded supportive care intervention or usual care.
Secondary measures include: patient quality of life, mood, coping style, satisfaction with care, and symptom burden.
This study will provide preliminary data to support the development of a larger, definitive, Phase III randomized clinical trial.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
As described above.
Tipo de estudio
Intervencionista
Inscripción (Actual)
50
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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Pennsylvania
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Pittsburgh, Pennsylvania, Estados Unidos, 15213
- University of Pittsburgh
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Ability to comprehend English
- Advanced CF
(Any of the following criteria will be indicative of "Advanced CF")
- Baseline supplemental oxygen requirement
- FEV1 ≤ 50%
- Baseline non-invasive mechanical ventilation requirement
- ≥ 2 hospitalizations in the past 12 months for respiratory complications related to CF
Exclusion Criteria:
- Prisoners
- Females who are pregnant
- Prior receipt of specialist SC services
- Cognitive impairments
- Patients younger than 18 years of age
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Cuidados de apoyo
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Sin intervención: Usual Care
Patients randomized to the control arm of this study will continue to receive the standard of high-quality CF care provided to all patients at the UPMC CF Center.
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Experimental: Supportive Care Intervention
Patients randomized to the intervention arm will receive a protocolized supportive care intervention from a palliative care nurse practitioner.
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Patients in the intervention arm of the study will see a SC specialist during regularly-scheduled CF clinic visits; per usual care, these visits should occur on a quarterly basis.
Using a structured intervention manual, these visits will span 30-60 minutes each.
Each visit will have a specific focus, such as: 1) comprehensive palliative care assessment; 2) symptom assessment and self-management; 3) advance care planning; and, 4) coping and resilience.
Patients requiring follow up with SC before the next CF appointment will receive telephone follow up or an extra SC visit at the discretion of the SC provider.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Feasibility of intervention
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
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Measured by: eligibility rate, approach-to-consent rate, approach-to-enroll rate, rate of missed intervention sessions, rate of missing data on patient-reported outcomes.
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Up to 9 months (+/- 4 weeks)
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Acceptability of intervention
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
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Measured by: proportion of participants who endorse the intervention as acceptable.
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Up to 9 months (+/- 4 weeks)
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Perceived effectiveness of intervention
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
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Measured by: proportion of participants who endorse that they believe the intervention to have been beneficial.
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Up to 9 months (+/- 4 weeks)
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Intervention fidelity
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
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Evaluate the fidelity of intervention delivery using structured visit checklists to be completed by the interventionist and research staff.
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Up to 9 months (+/- 4 weeks)
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Patient quality of life: Cystic Fibrosis Questionnaire-Revised (CFQ-R)
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
|
Change in QOL from baseline as measured by the Cystic Fibrosis Questionnaire-Revised (CFQ-R) at 9 months.
Due to the pilot nature of this trial, this measure will not be used to assess the efficacy of the intervention.
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Up to 9 months (+/- 4 weeks)
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Patient mood
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
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Change in mood from baseline using the Hospital Anxiety and Depression Scale (HADS), reported at 0, 3, 6, 9 months.
Due to the pilot nature of this trial, this measure will not be used to assess the efficacy of the intervention.
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Up to 9 months (+/- 4 weeks)
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Coping style
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
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Change in coping style from baseline using the Brief COPE, reported at 0, 3, 6, 9 months.
Due to the pilot nature of this trial, this measure will not be used to assess the efficacy of the intervention.
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Up to 9 months (+/- 4 weeks)
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Satisfaction with care
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
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Change in satisfaction with care from baseline using the FAMCARE-P13, reported at 0, 3, 6, 9 months.
Due to the pilot nature of this trial, this measure will not be used to assess the efficacy of the intervention.
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Up to 9 months (+/- 4 weeks)
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Symptom burden
Periodo de tiempo: Up to 9 months (+/- 4 weeks)
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Change in symptom burden from baseline using the Edmonton Symptom Assessment Scale (ESAS), reported at 0, 3, 6, 9 months.
Due to the pilot nature of this trial, this measure will not be used to assess the efficacy of the intervention.
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Up to 9 months (+/- 4 weeks)
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Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Healthcare utilization
Periodo de tiempo: Up to 12 months
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The investigators will evaluate various measures of healthcare utilization, such as: ED visits, unplanned hospitalizations, and healthcare expenditures.
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Up to 12 months
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Dio Kavalieratos, PhD, Section of Palliative Care and Medical Ethics; Division of General Internal Medicine, University of Pittsburgh
- Investigador principal: Joseph Pilewski, MD, Pulmonary, Allergy, and Critical Care Medicine Division; University of Pittsburgh
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
2 de marzo de 2016
Finalización primaria (Actual)
29 de noviembre de 2018
Finalización del estudio (Actual)
7 de octubre de 2019
Fechas de registro del estudio
Enviado por primera vez
14 de enero de 2016
Primero enviado que cumplió con los criterios de control de calidad
26 de enero de 2016
Publicado por primera vez (Estimar)
29 de enero de 2016
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
18 de febrero de 2020
Última actualización enviada que cumplió con los criterios de control de calidad
17 de febrero de 2020
Última verificación
1 de febrero de 2020
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- IRB#: PRO14110168
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
SÍ
Descripción del plan IPD
It is possible that the investigators may use the information obtained from this study in other research studies examining the treatment of Cystic Fibrosis.
This information may also be shared with other researchers here and at other research centers, but those researchers will never be provided with any personal identifiers that would allow them to learn participant's identity.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .