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Improving Resection Rates Among African Americans With NSCLC

8 mai 2020 mis à jour par: Wake Forest University Health Sciences
This is a randomized, interventional trial in which the navigation is the intervention. Phase is not applicable. The study is a randomized trial to evaluate the impact of a nurse-led patient navigation intervention in improving rates of receipt of lung-directed therapy with curative intent (LDTCI) among African Americans with early stage lung cancer. Study sites are cluster-randomized to either the usual care study arm or the to the navigation intervention study arm. Randomization occurred at the level of the study site rather than at the level of individual participants. There are two arms.

Aperçu de l'étude

Description détaillée

The burden to participants will be minimized to enhance retention. Patients in the usual care arm receive the current "gold standard" of treatment. The patients in the intervention arm are assigned to a PN, who helps to reduce the barriers to care that could negatively impact the patients' receipt of LDTCI. The telephone-administered survey is administered to all study participants at baseline and at 3-, 6-, and 12-months post-enrollment. It takes approximately 30-40 minutes to administer. The telephone mode of survey administration was chosen to reduce the number of visits that would be required by each patient. Interviews are scheduled at the convenience of the study participants. To further reduce burden to the study participants, the interviewers offer breaks during the interview process. Patients in both arms undergo standard therapy visits. Patients in the navigation arm receive standard therapy visits plus the navigation intervention. Outside of the standard therapy visits, no additional clinic visits are required of the study participants.

Once informed consent has been obtained and the informed consent document is received, the SSC/PN will communicate to the MUSC HCC study staff the participant's contact information and that the participant is ready for baseline survey administration. All the study surveys will be administered by trained MUSC HCC study staff via telephone. A survey answer guide will be provided to the participant either in-person or via mail prior to administration of the baseline survey.

Type d'étude

Interventionnel

Inscription (Réel)

248

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Delaware
      • Lewes, Delaware, États-Unis, 19958
        • Beebe Healthcare Tunnell Cancer Center
    • Georgia
      • Savannah, Georgia, États-Unis, 31405
        • Saint Joseph's/Candler Hospital
    • Illinois
      • Chicago, Illinois, États-Unis, 60612
        • Stroger Hospital of Cook County
    • Louisiana
      • New Orleans, Louisiana, États-Unis, 70121
        • Ochsner NCORP
    • Michigan
      • Royal Oak, Michigan, États-Unis, 48073
        • Beaumont Hospital - Royal Oak
    • Minnesota
      • Saint Louis Park, Minnesota, États-Unis, 55426
        • Metro-Minnesota NCORP
    • Nevada
      • Las Vegas, Nevada, États-Unis, 89106
        • Nevada Cancer Research Foundation
    • North Carolina
      • Winston-Salem, North Carolina, États-Unis, 27127
        • Wake Forest University Health Sciences
    • Pennsylvania
      • Philadelphia, Pennsylvania, États-Unis, 19111
        • Fox Chase
    • Virginia
      • Richmond, Virginia, États-Unis, 23298
        • Virginia Commonwealth University

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

21 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • AA race
  • Clinically suspicious or biopsy-proven, early stage NSCLC, and
  • Ages 21 years and older

Exclusion Criteria:

  • Previous history of lung cancer
  • Spread of newly diagnosed probably/proven lung cancer to other part of the body
  • Diagnosis of synchronous cancer other than non-melanoma skin cancer or lung cancer, and
  • Receipt of surgical resection or radiosurgery for lung cancer since diagnosis with probable/proven lung cancer

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Recherche sur les services de santé
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur actif: Usual Care Arm
Participants who are assigned to the usual care arm may receive the following services: complete staging work-up (CT/PET scan and possible mediastinoscopy), surgical consultation with a general or cardiothoracic surgeon, cardiac clearance and/or pulmonary function testing (if deemed necessary by the evaluating surgeon), surgical resection (wedge resection, lobectomy, pneumonectomy, or radiosurgery, as indicated by the size and location of the tumor), and adjuvant therapy (radiotherapy and/or chemotherapy, as determined by the intraoperative findings and pathology results).
Usual care includes: complete staging work-up (CT/PET scan and possible mediastinoscopy), surgical consultation with a general or cardiothoracic surgeon, cardiac clearance and/or pulmonary function testing (if deemed necessary by the evaluating surgeon), surgical resection (wedge resection, lobectomy, pneumonectomy, or radiosurgery, as indicated by the size and location of the tumor), and adjuvant therapy (radiotherapy and/or chemotherapy, as determined by the intraoperative findings and pathology results).
Expérimental: Intervention Arm

The PN will provide each patient with a copy of the NCI's "What You Need to Know About Lung Cancer" booklet and encourage them to re-contact his/her primary care physician (or the physician who diagnosed their probable/proven NSCLC) to discuss treatment options.

The PNs will provide patients with their contact information and brief patients on their role. The PNs will navigate study participants for up to 4 months (16 weeks, 112 days) after NSCLC diagnosis, until the patient is deemed ineligible for LDTCI (i.e., lung resection or SBRT) by their physician(s), until receipt of LDTCI, or death (whichever comes first).

During the EPDPN intervention period, PNs will contact each intervention group participant by telephone (or in-person) on weekly basis (at minimum).

The proposed Intervention (EPDPN) will be administered by the PNs at the intervention sites on an outpatient basis. Several defining, fundamental characteristics of the PNs will ensure consistency of the intervention delivery across the various study sites.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Receipt of LDTCI
Délai: 12 Months Post-Enrollment
Receipt of lung-directed therapy with curative intent (LDTCI), Inquiry at time of follow-up survey, confirmed by medical record review
12 Months Post-Enrollment

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Receipt of Surgical and/or Radiation Oncology Consultation Confirmed by Medical Record Review
Délai: Baseline, 3, 6, 9, and 12 Months Post-Enrollment
• Receipt of surgical and/or radiation oncology consultation (defined as outpatient or inpatient consultation with a general or cardiothoracic surgeon and/or radiation oncologist to discuss LDTCI for NSCLC within 4 months post-diagnosis of probable/proven, early stage NSCLC).
Baseline, 3, 6, 9, and 12 Months Post-Enrollment
Time to LDTCI (For Pts. Who Received LDTCI Only) Confirmed by Medical Record Review
Délai: Baseline, 3, 6, 9, and 12 Months Post-Enrollment
Time to LDTCI (For Pts. Who Received LDTCI Only). Inquiry at Time of Follow-Up Survey, Confirmed by Medical Record Review. Baseline, 3, 6, 9, and 12 Months Post-Enrollment
Baseline, 3, 6, 9, and 12 Months Post-Enrollment
Satisfaction with Care Received, Patient Satisfaction(REF) (28 items)
Délai: 6 Months Post-Enrollment
Satisfaction with Care Received, Patient Satisfaction(REF) (28 items). 6 Months Post-Enrollment
6 Months Post-Enrollment
Time of Death, Follow-up Survey, Confirmed by Medical Record Review
Délai: Baseline, 3, 6, 9, and 12 Months Post-Enrollment
Time of Death. Inquiry at Time of Follow-Up Survey, Confirmed by Medical Record Review , inquiry of cancer registries at study sites, and inquiry of Social Security Death Index. Baseline, 3, 6, 9, and 12 Months Post-Enrollment.
Baseline, 3, 6, 9, and 12 Months Post-Enrollment

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Kathryn E Weaver, PhD, Wake Forest Universith Health Sciences

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

23 avril 2015

Achèvement primaire (Réel)

23 août 2019

Achèvement de l'étude (Réel)

9 septembre 2019

Dates d'inscription aux études

Première soumission

17 juin 2013

Première soumission répondant aux critères de contrôle qualité

24 juin 2013

Première publication (Estimation)

25 juin 2013

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

12 mai 2020

Dernière mise à jour soumise répondant aux critères de contrôle qualité

8 mai 2020

Dernière vérification

1 mars 2020

Plus d'information

Termes liés à cette étude

Plan pour les données individuelles des participants (IPD)

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Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

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Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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