Developing and Testing the Effectiveness of Smart Healthcare Assisted Individualized Symptom Management Education and Home-based Exercise on Frailty, Treatment-related Adverse Events and Quality of Life in Advanced Gastric Cancer Patients Receiving Immunotherapy
The goal of this randomized controlled intervention is to develop and evaluate the effectiveness of the nurse-led with AI chatbot Individualized Symptom Management Education and Home-based Exercise (AI-ISME&HE) based on The Theory of Symptom Self-Management (TSSM) on frailty, self-efficacy in cancer care, trAE, and quality of life in advanced gastric cancer patients receiving immunotherapy. The main questions it aims to answer are:
- Can AI-ISME&HE reduces frailty in advanced gastric cancer patients receiving immunotherapy?
- Can AI-ISME&HE increases quality of life in advanced gastric cancer patients receiving immunotherapy?
- Can AI-ISME&HE increases self-efficacy in advanced gastric cancer patients receiving immunotherapy?
- Can AI-ISME&HE reduces all-caused death in advanced gastric cancer patients receiving immunotherapy within two years? Researchers will compare usual routine care to see if AI-ISME&HE can reduce frailty, all-caused death and increase quality of life and self-efficacy.
Participants will not be blinded, but the outcome evaluator will be blinded. The participants will be asked to complete three tasks for 12 weeks:
- Self-reporting treatment-related adverse events
- Interacting with AI-ISME&HE for seeking information related to self-management educational materials, including symptom management with the most reported trAEs and prevention from frailty
- ViviFrail-based exercise
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Shiow-Ching Shun, PhD
- Numero di telefono: +886911268998
- Email: scshun@nycu.edu.tw
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- age ≥18 years
- diagnosed as AGC (TNM: T2~T4, N>0, Any M, Stage: III~IV, or unresectable GC)
- scheduled to receive the first cycle of immunotherapy
- willingness to provide written informed consent after receiving a full explanation of the study
Exclusion Criteria:
- a diagnosis of another type of cancer within the past five years
- inability to communicate clearly
- a diagnosis of dementia
- acute pulmonary embolism
- acute myocardial infarction
- extremity bone fracture within the past three months
- bone metastasis
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Altro
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: Intervention
AI-ISME&HE intervention group
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Nessun intervento: Control
Usual routine care
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Level of Frailty Assessed by The Short Physical Performance Battery (SPPB)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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The SPPB score from 0-12 points, with 10-12 indicating robust, 7-9 indicating prefrail, and 4-6 indicating frail.
It has good reliability (ICC range from 0.82-0.92)
and validity.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Level of Frailty Assessed by Comprehensive Geriatrics Assessment
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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A total of 8 domains were used to comprehensively assess frailty in cancer patients: Functional status, Comorbidity, Nutrition, Polypharmacy, Social support, Cognition, and Mood. 0 abnormal domains indicate robust, any 1 abnormal indicates pre-frail, and 2 or more abnormality indicate frailty. Each domain can be assessed by different tools. In this study, we chose the tools according as follows:
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Level of Frailty Assessed by Geriatric 8 (G8)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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The G8 score from 0-17 points, with score ≤14 indicating frailty.
It has good sensitivity (86.9%) in cancer patients
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Level of Frailty Assessed by Taiwan Cancer Frailty Tool (TCFT)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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The TCFT score from 0-5 points, with score >0 indicating frailty.
It has good ROC values of 0.857 in cancer patients
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Score of Quality of Life Assessed by The Functional Assessment of Cancer Therapy - General - 7 Item Version (FACT-G7)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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It includes 7 items and compromised physical well-being (3 items), emotional well-being (1 items), and functional well-being (3 items).
The score of each item is from 0 (not at all) to 5 (very much), and the total score ranging from 0 to 28, with a higher score indicating better quality of life.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Level of Self-efficacy Assessed by The Modified Cancer Behavior Inventory (CBI)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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It is a 0-10 Likert-type scale, where 0 indicates no confidence at all and 10 indicates fully confidence.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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All Cause Mortality After 2 Year Follow-up
Lasso di tempo: Record patient's survival status at baseline, 1 year after baseline, and 2 year after baseline.
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The survival status of the patients will be followed by medical record.
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Record patient's survival status at baseline, 1 year after baseline, and 2 year after baseline.
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Level of Symptom Severity Assessed by The Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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The 14 symptoms include fatigue, headache, shortness of breath, nausea/vomiting, rash, diarrhea, decreased appetite, numbness/tingling, general pain, blurred vision, constipation, abdominal pain, itching, and dizziness.
Symptoms are assessed by using five-point Likert-type scale to rate symptom frequency (never, rarely, occasionally, frequently, almost constantly), severity (none, mild, moderate, severe, very severe), and interference (not at all, a little bit, somewhat, quite a bit, very much) in the past 7 days.
It can composite grading based on an algorithm into grade 0 to 3.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Level of Nutrition Status Assessed by The Mini Nutritional Assessment Short Form (MNA-SF)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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It includes 6 items relating to food intake in the past three months, weight loss in the past three months, physical activity, stress, dementia or depression, and body mass index (BMI).
The total score ranges from 0-14, with 12-14 representing well, 8-11 representing at risk, and 0-7 representing malnutrition.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Level of Cognitive Function Assessed by The Montreal Cognitive Assessment (MoCA)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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The scale consists of 12 items with a total score ranging from 0 to 30, assessing cognitive function across eight domains, including visuospatial construction, executive function, naming, memory, attention, language, abstraction, delayed recall, and orientation.
A score of 24 below indicates cognitive impairment.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Level of Depression Assessed by The Patient Health Questionnaire-9 (PHQ-9)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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PHQ-9 is a depression muddle from the complete PHQ, including nine DSM-IV criteria for depression, each item scores from 0-3, with a total score range from 0-27.
A higher score indicates higher severity of depression, with a score 0-4 as none, 5-9 as mild, and ≥ 10 as moderate-severe depression.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Level of Physical Function Assessed by Grip Strength (GS)
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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GS will be assessed by JAMAR hydraulic dynamometer, which show good reliability.
The participants will be asked to sit in the neutral position with their elbows flexed at 90° and resting at their sides.
Next, they need to squeeze the handle of the dynamometer for 3-5 seconds as hard as possible for 3 trials on dominant hand with a rest of 60 seconds.
The average and the maximum of the grip strength (kg) will be recorded.
Female with GS ≤ 16 kg and male ≤ 26.7 kg refer to frailty.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Changes of Body Composition Assessed by Body Composition Machine
Lasso di tempo: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Body composition will be examined by ACCUNIQ BC300 which is a lightweight, foldable professional body composition analyzer that utilizes bioelectrical impedance analysis (BIA) technology.
Through eight electrodes and three different frequencies (5, 50, 250 kHz), it performs full-body and segmented (arms, legs, torso) measurements, quickly providing detailed data such as body fat, muscle mass, and water content with high accuracy within 5 minutes.
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Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
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Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Investigatori
Investigatori
- Cattedra di studio: I-Wen Chang, PhD, Department of Nursing, Taipei Veterans General Hospital
Studiare le date dei record
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Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- 2026-02-009CC
- 115-2314-B-A49 -016 -MY3 (Altro numero di sovvenzione/finanziamento: National Science and Technology Council)
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