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Effectiveness and Implementation of 'Supportive and Palliative Care Review Kit in Locations Everywhere' (SPARKLE-2)

30 luglio 2026 aggiornato da: National Cancer Centre, Singapore

Effectiveness and Implementation of 'Supportive and Palliative cAre Review Kit in Locations Everywhere' (SPARKLE-2) - A Randomized Controlled Trial

Advanced cancer patients often experience significant physical and emotional symptoms, which can lead to frequent hospital visits and reduced quality of life. Although palliative care can help manage these symptoms and improve well-being, it is often introduced too late.

A proactive symptom monitoring model, SPARKLE-2 aims to identify patients who need palliative care earlier by regularly checking their symptoms using a simple questionnaire. Patients with concerned symptoms will receive timely support from the palliative care team, with the goal of improving their quality of life, reducing unnecessary hospital admissions, and helping more patients receive care in the community rather than in hospital. In the earlier SPARKLE-1 study, it showed the improvement of patients' physical wellbeing. SPARKLE-2 seeks to test the effectiveness among advanced cancer patients with unplanned hospital visits while simultaneously collecting data on real-world implementation.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

To evaluate the effectiveness of SPARKLE-2, we will conduct randomized controlled trial comparing clinical outcomes at 3 months between patients receiving usual care and intervention. For longer-term impact of palliative care, we will also measure patient outcomes at 6, 9, and 12 months. To evaluate ways to improve implementation, the Consolidated Framework for Implementation Research (CFIR) will be used to systematically identify processes that influence implementation outcomes.

The specific aims and hypotheses of this mixed methods study are:

  1. Assess the effectiveness of SPARKLE-2 on health-related quality of life and healthcare utilization among patients with advanced cancer. We hypothesize that the SPARKLE-2 group compared to the usual care group participants will have better health-related quality of life, better health status, earlier palliative care utilisation, and less acute healthcare utilisation.
  2. Assess implementation processes of SPARKLE-2. We will assess acceptability, appropriateness, and feasibility through a structured survey among healthcare providers. Also, we will assess fidelity through completion rate of IPOS screening questionnaires and compliance with clinical response pathways. Implementation costs will be captured from the healthcare system's perspective prospectively using an activity-based costing approach.
  3. Assess contexts and mechanisms that bring about SPARKLE-2 outcomes. We will interview patients, caregivers and healthcare providers who were involved in SPARKLE-2 to explore their perspectives on factors, including facilitators and barriers, that bring about intervention effects.

Tipo di studio

Interventistico

Iscrizione (Stimato)

300

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

  • Singapore
      • Singapore, Singapore, 169608
        • Singapore General Hospital
        • Contatto:
          • Dr Yi ZHOU, MD, MRCP (UK), MMed
      • Singapore, Singapore, 168583
        • National Cancer Centre, Singapore
        • Contatto:
          • Dr Grace Meijuan YANG, MD, MPH, PhD

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Inclusion criteria for patients:

    1. 21 years old or older
    2. Diagnosed of advanced cancer diagnosis, defined as metastatic or recurrent/ progressive Stage III/IV solid tumour
    3. Has an unplanned hospital admission and expected to be discharged home
    4. Able to speak English or Mandarin Chinese or Malay

    5. Able to provide informed consent

      Additional inclusion criteria for patient participants of semi-structured interviews are:

    6. Enrolled in the SPARKLE-2 RCT, whether randomized to the SPARKLE intervention or usual care group and regardless of fidelity to trial procedures.

  • Inclusion criteria for caregivers:

    1. 21 years old or older
    2. Self-endorsing or identified by an enrolled patient as a spouse/partner, relative or friend who knows them well and who provides support due to their cancer
    3. Able to speak English or Mandarin Chinese or Malay
    4. Able to provide informed consent

  • Inclusion criteria for healthcare providers:

    1. 21 years old or older
    2. Healthcare professional who is involved in the clinical care of patients with advanced cancer for at least 50% of their work hours
    3. Able to provide informed consent
    4. Involved in the processes of the SPARKLE-2

Exclusion Criteria:

  • Exclusion criteria for patients:

    1. Assessed by the treating physician as unable to complete study procedures
    2. Unable to complete patient-reported outcome measures

  • Exclusion criteria for caregivers:

    1. Unable to complete interviews

  • Exclusion criteria for healthcare providers:

    1. Healthcare professionals that are not providing care for cancer patients.
    2. Unable to complete interviews

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Ricerca sui servizi sanitari
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: SPARKLE-2 Intervention
Participants will receive SPARKLE-2 immediately at bi-weekly interval.
Comportamentale: SPARKLE-2

Patients will receive a Short Message Service (SMS) text on their phone every 2 weeks, inviting them to complete a self-reported online six-item Integrated Palliative care Outcome Scale (IPOS) questionnaire over a period of 12 months.

If a patient records higher scores on any IPOS symptom domains, a programme coordinator will then make a phone call to the patient for further assessment of symptoms and concerns identified. If indicated, the programme coordinator would then initiate management of the symptoms and concerns according to structured clinical management protocols.
Nessun intervento: Usual Care
Participants will not receive any study intervention (SPARKLE-2) and will continue to receive their usual care.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Quality of life score measured using the Functional Assessment of Chronic Illness Therapy - Palliative (FACIT-Pal)
Lasso di tempo: 12 weeks.
FACIT-Pal is a 46-item measure with a quality-of-life scale (4 domains: physical, emotional, social, and functional well-being) and a palliative care subscale. It has demonstrated internal consistency, reliability and validity for persons with advanced cancer. Quality of life is scored on a scale of 0 to 184, with higher scores indicating better outcomes.
12 weeks.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Quality of life score measured using the Functional Assessment of Chronic Illness Therapy - Palliative (FACIT-Pal)
Lasso di tempo: Every 12 weeks from baseline, till the point of patient death, or till week 48, whichever is earlier.
The proposed FACIT-Pal assessment schedule is to evaluate longitudinal changes in quality of life over time.
Every 12 weeks from baseline, till the point of patient death, or till week 48, whichever is earlier.
Palliative care concerns measured using the Integrated Palliative Care Outcomes Scale (IPOS)
Lasso di tempo: Every 2 weeks from baseline, till the point of patient death, or till week 48, whichever is earlier.
IPOS is a brief measure of palliative care problems, covering physical and psychological symptoms, social and spiritual issues, communication, information needs, and practical concerns. Each item is rated on a Likert scale of 0 to 4. Higher scores indicate that symptoms and concerns affect the person more. IPOS has been translated to Chinese and validated in Singapore.
Every 2 weeks from baseline, till the point of patient death, or till week 48, whichever is earlier.
Health states measured using the EuroQOL Group 5-Dimension Health-related Quality of Life Measurement (EQ-5D-5L)
Lasso di tempo: Baseline, 12 weeks, 18 weeks, 27 weeks, and 48 weeks.
EQ-5D-5L contains a 5-item descriptive system measuring 5 dimensions: mobility, self-care, usual activities, pain/ discomfort, anxiety/ depression; a visual analogue scale measuring overall health status. The tool has been validated in Singapore.
Baseline, 12 weeks, 18 weeks, 27 weeks, and 48 weeks.
Acute healthcare utilization.
Lasso di tempo: Baseline until death or end of the study, up to 48 weeks.
Frequency of Emergency Department (ED) visits.
Baseline until death or end of the study, up to 48 weeks.
Inpatient healthcare utilization and the intervention's impact on inpatient healthcare utilization.
Lasso di tempo: Baseline until death or end of the study, up to 48 weeks.
Number of hospital admissions.
Baseline until death or end of the study, up to 48 weeks.
Healthcare expenditure associated with patient care and the economic impact on intervention.
Lasso di tempo: Baseline until death or end of the study, up to 48 weeks.
Total hospital charges.
Baseline until death or end of the study, up to 48 weeks.

Altre misure di risultato

Misura del risultato
Misura Descrizione
Lasso di tempo
Appropriateness and feasibility
Lasso di tempo: Up to 48 weeks.
To explore perspectives on factors, including facilitators and barriers among patients, caregivers and healthcare workers. Semi-structured interviews conducted using an interview guide developed based on the Consolidated Framework for Implementation Research (CFIR).
Up to 48 weeks.
Implementation cost
Lasso di tempo: Up to 48 weeks.
Process maps and project records detailing key intervention activities to elucidate cost of involved personnel and resources through a time-tracking system and an activity-based costing approach.
Up to 48 weeks.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

National Cancer Centre, Singapore

Investigatori

  • Cattedra di studio: Grace Meijuan YANG, MD, MPH, PhD, National Cancer Centre, Singapore

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Collegamenti utili

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 agosto 2026

Completamento primario (Stimato)

31 marzo 2029

Completamento dello studio (Stimato)

31 marzo 2029

Date di iscrizione allo studio

Primo inviato

30 luglio 2026

Primo inviato che soddisfa i criteri di controllo qualità

30 luglio 2026

Primo Inserito (Effettivo)

4 agosto 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

4 agosto 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

30 luglio 2026

Ultimo verificato

1 luglio 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • 2026-0459

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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