Cancer Symptom Monitoring Telephone System With Nurse Practitioner (NP) Follow up
2017年2月28日 更新者：Kathleen Mooney、University of Utah
Telephone Linked Care: An IT Enabled Integrated System for Cancer Symptom Relief
The purpose of this prospective trial is to test a daily telephone based automated symptom monitoring and response system to track and further treat unrelieved symptoms for patients living at home during chemotherapy treatment as compared with usual care which consists of patients calling their oncology provider for symptom concerns.
調査の概要
詳細な説明
The purpose of this prospective trial is to test a daily telephone based automated symptom monitoring and response system to track and further treat unrelieved symptoms for patients living at home during chemotherapy treatment as compared with usual care which consists of patients calling their oncology provider for symptom concerns.
For the intervention group, the monitoring system is paired with automated delivery of self-care suggestions tailored to the specific symptom profile the patient reported and also automatically 'alerts' the study oncology nurse practitioner about unrelieved symptoms.
The nurse practitioner, utilizing national evidence based symptom guidelines for symptoms at moderate to severe levels calls the patient and further assesses and intensifies symptom treatment.
The usual care group called the system daily and reported similar data but did not receive self-care coaching or notification of unrelieved symptoms to the study nurse practitioner.
On every call, the usual care group was told to follow the standard procedure of calling their oncology providers for symptom concerns.
The specific aims of the study are to test whether the symptom monitoring intervention reduces presence, severity and distress of 11 symptoms.
The symptoms monitored in the project were nausea/vomiting, pain, sore mouth, numbness & tingling, diarrhea, trouble thinking, trouble sleeping, changes in appearance, depressed mood, anxiety, and fatigue.
Secondary outcomes tested whether the intervention improved functional performance and decreased interference with activity when compared with the usual care attentional control group.
Other aims compare self care strategies utilized and their perceived effectiveness and document patient satisfaction with the monitoring system.
研究の種類
介入
入学 (実際)
358
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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Tennessee
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Nashville、Tennessee、アメリカ、37232
- Vanderbilt-Ingram Cancer Center
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Utah
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Salt Lake City、Utah、アメリカ、84132
- University of Utah Huntsman Cancer Institute
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
18年歳以上 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
- Adult (age 18 or over)
- Have a histological diagnosis of cancer
- a life expectancy of at least 3 months and cognitively able to participate
- Beginning a new course of chemotherapy that is planned for a minimum of 3 cycles;
- care is under the direction of one of the 8 designated provider teams;
- English speaking;
- has access to a telephone on a daily basis and is able to use the phone unassisted as verified by the study staff during participant orientation.
Exclusion Criteria:
- patients who are receiving concurrent radiation therapy (as they would have daily contact with the health care system);
- patients who see the provider team for recommendation of a chemotherapy regimen but treatment is then administered at a different site by other providers.
- Patients receiving therapy agents that result in a drug related fever or therapy agents that are not anticipated to cause any of the 11 symptoms.
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：支持療法
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
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介入なし：Usual Care
Patients in the usual care group called the automated monitoring system daily to report presence, severity, and distress for 11 common symptoms.
The attentional control group received equivalent contact time with the automated system including identical voice and assessment questions.
Patients did not hear self-care messages during the call and the data were not available for clinical action by the study nurse practitioner.
Patients were told on every phone call to call their oncology providers if they had concerns about their symptoms which is usual care for symptom follow up in oncology.
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実験的：Symptom Alert and Coaching
Patients in the Symptom Alert and Coaching arm called the automated monitoring system daily to report presence, severity, and distress on 11 symptoms. The system provided automated self care coaching based on the symptoms reported and automatically generated alerts to the study NP if symptoms exceeded preset thresholds. Two thresholds were set: a simple alert when severity or distress was 4 or greater on a 10 point scale and trend alerts based on a pattern of moderate severity over several days. The alerts went into a case management site. The study NP logged into the system daily and responded to the alerts within 24 hours by calling patients to further assess the symptoms and to intensify symptom treatment using evidence based guidelines. |
Patients heard self-care messages when they reported a symptom was present.
The Symptom Alert and Coaching intervention alerted study nurse practitioners of unresolved symptoms daily.
The NPs responded to all alerts generated by patients and using evidence based guidelines, called patients to further assess and to intensify symptom treatment.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Patient reported symptom levels
時間枠：Daily patient reports of symptom levels were made for an entire new course of chemotherapy or 6 months whichever occurred first.
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During daily automated calls, patients provided information about common chemotherapy symptoms on a 0-10 scale.
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Daily patient reports of symptom levels were made for an entire new course of chemotherapy or 6 months whichever occurred first.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Medical Encounters Telephone Interview
時間枠：Each week patients reported during the daily symptom monitoring call whether they had a medical encounter for an entire new course of chemotherapy or 6 months whichever occurred first.
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Each week patients reported during their daily phone calls whether or not they had been in contact with a health care provider, were seen in an emergency department or urgent care facility, or had an unscheduled hospitalization.
If they reported they did have a medical encounter, the research staff would call and conduct a short telephone interview to collect data about the nature of the medical encounter including whether the medical encounter was related to the symptoms being monitored.
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Each week patients reported during the daily symptom monitoring call whether they had a medical encounter for an entire new course of chemotherapy or 6 months whichever occurred first.
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Patient reported symptom related interference with daily activities
時間枠：Reported daily for an entire new course of chemotherapy or 6 months whichever occurred first.
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This is a one item question asked daily during the symptom monitoring call about the level of interference their symptoms had on their daily activities (0-10 scale).
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Reported daily for an entire new course of chemotherapy or 6 months whichever occurred first.
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SF-36 Functional Status
時間枠：Monthly for an entire new course of chemotherapy or 6 months whichever occurred first.
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Functional status was measured monthly using the SF-36.
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Monthly for an entire new course of chemotherapy or 6 months whichever occurred first.
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Work interference
時間枠：Reported daily for an entire new course of chemotherapy or 6 months whichever occurred first.
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For patients who indicated they worked during their treatment, the system asked daily if they missed work if it was a regular workday.
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Reported daily for an entire new course of chemotherapy or 6 months whichever occurred first.
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Work Limitations Questionnaire
時間枠：Monthly for an entire new course of chemotherapy or 6 months whichever occurred first.
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The 25 item patient-reported Work Limitations Questionnaire was used to measure work performance.
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Monthly for an entire new course of chemotherapy or 6 months whichever occurred first.
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Patient End of Study Telephone Interview
時間枠：Administered once, at the end of the patients' participation in the study which was following an entire new course of chemotherapy or 6 months whichever occurred first.
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An End of Study Telephone Interview was conducted at the end of a patient's participation in the project to obtain data on patient satisfaction with the symptom monitoring system and to obtain suggestions for improvement of the system.
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Administered once, at the end of the patients' participation in the study which was following an entire new course of chemotherapy or 6 months whichever occurred first.
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Evaluation of automated and other self care strategies used and their effectiveness
時間枠：Weekly for an entire new course of chemotherapy or 6 months whichever occurred first.
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The symptom monitoring system tracked when an intervention participant heard a self care strategy during the course of the week.
Each week patients would report on how helpful (1-10 scale) the automated self care measures were for the specific symptoms.
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Weekly for an entire new course of chemotherapy or 6 months whichever occurred first.
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
スポンサー
捜査官
- 主任研究者：Kathleen H Mooney, PhD、University of Utah
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2007年9月1日
一次修了 (実際)
2012年4月1日
研究の完了 (実際)
2012年4月1日
試験登録日
最初に提出
2013年10月22日
QC基準を満たした最初の提出物
2013年10月25日
最初の投稿 (見積もり)
2013年11月1日
学習記録の更新
投稿された最後の更新 (実際)
2017年3月1日
QC基準を満たした最後の更新が送信されました
2017年2月28日
最終確認日
2017年2月1日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- 17472
- 5R01CA120558 (米国 NIH グラント/契約)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
いいえ
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