- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT05142345
Care Transition Intervention for Hospitalized Patients With Advanced Cancer
Randomized Trial of a Care Transition Intervention for Hospitalized Patients With Advanced Cancer
연구 개요
상세 설명
To address the rising incidence and burden of hospital readmissions for patients with advanced cancer, the investigators developed a population-specific care transition intervention based upon the scholarly literature and our qualitative study. The intervention, CONTINUUM (CONTINUity of care Under Management by video visits), consists of a video visit conducted by an oncology NP within three business days of hospital discharge, to: (1) reconcile medications, (2) manage symptoms, (3) review the post-hospital care plan for hospitalization-specific issues, and (4) schedule follow-up with the outpatient oncology team.
From 01/07/21 to 05/28/21, the investigators conducted a pilot trial of CONTINUUM in 48 patients with advanced cancer recently discharged from the Massachusetts General Hospital Cancer Center (NCT04640714). The investigators found that the intervention was feasible and acceptable in our population.
The investigators are now conducting a randomized controlled trial of the CONTINUUM intervention versus standard of care, to study whether CONTINUUM improves patients' confidence in managing their health condition, as measured by the Patient Activation Measure-13. The investigators will also assess the efficacy of CONTINUUM for improving patient satisfaction with clinician communication, and physical and psychological symptom burden. Lastly, the investigators will explore the effect of the intervention on hospital readmissions within 30-days.
Study procedures include random assignment to either the CONTINUUM intervention or standard oncology care following hospital discharge, questionnaires and medical record data collection.
Participants are expected to be on the study for up to 40 days after hospital discharge.
It is anticipated that about 286 people will take part in this research study.
연구 유형
등록 (예상)
단계
- 해당 없음
연락처 및 위치
연구 연락처
- 이름: Jennifer S Temel, MD
- 전화번호: (617) 724-4000
- 이메일: jtemel@partners.org
연구 장소
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Massachusetts
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Boston, Massachusetts, 미국, 02114
- 모병
- Massachusetts General Hospital Cancer Center
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연락하다:
- Jennifer S Temel, MD
- 전화번호: 617-724-4000
- 이메일: jtemel@mgh.harvard.edu
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수석 연구원:
- Jennifer S Temel, MD
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Age >= 18 years
- First unplanned admission to the oncology service at Massachusetts General Hospital (MGH) since diagnosis of advanced cancer
- Known diagnosis of advanced breast, thoracic, genitourinary, or gastrointestinal cancer
- Receiving ongoing oncology care at MGH
- Verbal fluency in English
- Internet/wifi or telephone access
- Residing in Massachusetts at the time of hospital discharge
Exclusion Criteria:
- Admitted electively
- Discharged to a location other than home or expired during admission
- Discharged with hospice services
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 지지 요법
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
---|---|
실험적: CONTINUUM Intervention Post-Hospital Discharge
Participants will receive CONTINUUM intervention visit with a nurse practitioner within three business days of hospital discharge and complete questionnaires about their cancer and care.
|
The intervention, CONTINUUM (CONTINUity of care Under Management by video visits), consists of a video visit conducted by an oncology nurse practitioner within three business days of hospital discharge, to: (1) reconcile medications, (2) manage symptoms, (3) review the post-hospital care plan for hospitalization-specific issues, and (4) schedule follow-up with the outpatient oncology team.
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활성 비교기: Usual Care Post-Hospital Discharge
Participants will receive standard oncology care following hospital discharge with follow-up appointments scheduled per primary team and participant preferences.
Participants will complete questionnaires about their cancer and care.
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Patients assigned to the usual care group will have their post-discharge follow-up scheduled per hospital, outpatient oncology team, and patient preference.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Patients' Confidence in Managing their Health Condition using the Patient Activation Measure-13 (PAM-13)
기간: Baseline to 10-15 days after hospital discharge
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Compare change in the PAM-13 from baseline to 10-15 days post-discharge between study groups.
The PAM-13 is scored 0-100 with higher scores indicating greater confidence in managing one's health condition.
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Baseline to 10-15 days after hospital discharge
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Quality of Communication using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Communication subscale
기간: Up to 10-15 days after hospital discharge
|
Compare differences in CAHPS-Communication at up to 10-15 days post-discharge between study groups.
CAHPS-Communication has a composite score (score range 0-20) with higher scores indicating better satisfaction.
As recommended by CAHPS, we will also analyze specific differences in CAHPS-Communication individual items, which relate to patients' assessment of whether clinicians discussed 1) illness course expectations, 2) what is most important to the patient, and 3) how the treatment plan should match what is most important to the patient.
These items are scored as "Yes" vs. "No" responses.
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Up to 10-15 days after hospital discharge
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Symptom Burden using the Edmonton Symptom Assessment Scale (ESAS-r)
기간: Baseline to 10-15 days after hospital discharge
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Compare change in the Edmonton Symptom Assessment System-Revised (ESAS-r) total score and physical sub-scale between baseline and 10-15 days of discharge between study groups.
Scores on the ESAS-r range from 0-100 with higher scores indicating worse symptom burden.
Scores on the ESAS-Physical sub-scale range from 0-70 with higher scores indicating worse symptom burden.
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Baseline to 10-15 days after hospital discharge
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Psychological Symptoms using the Patient Health Questionnaire-4 (PHQ-4)
기간: Baseline to 10-15 days after hospital discharge
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Compare change in the Patient Health Questionnaire-4 (PHQ-4) between baseline and 10-15 days of discharge between study groups.
The PHQ-4 is a 4-item tool that contains two 2-item subscales assessing depression and anxiety symptoms.
Both subscales and the composite PHQ-4 score can also be evaluated continuously, with higher scores indicating worse psychological distress.
Scores on each subscale range from 0 to 6.
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Baseline to 10-15 days after hospital discharge
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기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
30-day Hospital Readmissions
기간: Up to 30 days after discharge
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Compare hospital readmissions within 30 days of discharge between study groups.
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Up to 30 days after discharge
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공동 작업자 및 조사자
수사관
- 수석 연구원: Jennifer S Temel, MD, Massachusetts General Hospital
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (예상)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- 21-501
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
IPD 계획 설명
IPD 공유 기간
IPD 공유 액세스 기준
IPD 공유 지원 정보 유형
- 연구_프로토콜
- 수액
- ICF
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
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