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Cancer & Chemotherapy Symptom Management Using an Automated Telephone Reporting System

28 februari 2017 bijgewerkt door: Kathleen Mooney, University of Utah

Telephone Linked Care for Cancer Symptom Management

The purpose of this study was to test the efficacy of a computer-based automated symptom monitoring telephone system used by patients who received chemotherapy for their cancer to communicate unrelieved symptoms they experienced to their oncology providers.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

The purpose of this study was to test the efficacy of a computer-based automated symptom monitoring telephone system used by patients who received chemotherapy for their cancer to communicate unrelieved symptoms they experienced to their oncology providers. The symptoms monitored in the project were nausea/vomiting, pain, sore mouth, diarrhea, constipation, depressed mood, anxiety, trouble sleeping, and fatigue. The study randomly assigned participants into either the intervention group or the group that received usual care from their oncology providers without alert notifications. All participants called the automated system daily to report their symptom presence, severity, and distress. When participants in the intervention group rated symptoms at moderate (4-7) to severe (8-10) levels an e-mail alert report of their symptom information was sent to the participant's medical oncologist and oncology nurse. The usual care group also reported symptoms daily to the automated system but their information was not sent to the providers. Participants in the usual care group were told daily to call their oncology provider if they had concerns about their symptoms. The two study groups were compared over chemotherapy cycles 2 and 3 on symptom presence, severity, and distress. Functional status, patient reported degree of symptom interference with normal activities, and work attendance if they had indicated that they worked during their treatment were also recorded. In addition, the groups were compared for the number and purpose of unscheduled patient-provider contacts, visits to the emergency department or urgent care facility, and unscheduled hospitalizations.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

250

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Verenigde Staten
    • Massachusetts
      • Boston, Massachusetts, Verenigde Staten, 02118
        • Boston Medical Center
    • South Carolina
      • Greer, South Carolina, Verenigde Staten, 29650
        • South Carolina Community Oncology Practice
    • Utah
      • Salt Lake City, Utah, Verenigde Staten, 84112
        • University of Utah Huntsman Cancer Institute

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Adult (18 or older)
  • Histological Diagnosis of Cancer
  • Life Expectancy of at least 6 months
  • Cognitively able to participate (verified by provider team)
  • Initiated a course of new Chemotherapy that is planned for a minimum of 3 cycles
  • Had Poorly controlled symptoms during the first cycle of chemotherapy
  • Care under the direction of one of the designated provider teams
  • English or Spanish speaking
  • Has access to a telephone on a daily basis
  • Able to use the telephone unassisted

Exclusion Criteria:

  • Receiving concurrent radiation therapy because they would be in daily contact with oncology care providers.
  • Patients seeing the provider team for recommendation of chemotherapy regimen but other providers then administer treatment at different site
  • Patients receiving a treatment regimen with only biotherapy agents or agents not associated with the symptoms monitored

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Ondersteunende zorg
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Provider Unrelieved Symptom Alert
Patients in the intervention arm called the automated monitoring system daily to report presence, severity and distress on a 1-10 scale for nine symptoms. The system immediately sent an emailed symptom alert report to their oncologist and oncology nurse if symptoms exceeded preset thresholds (moderate to severe levels). Two thresholds were set: a simple alert when severity or distress was 4 or greater on the 10 point scale and trend alerts based on a pattern of moderate severity over several days.
Ander: Provider Unrelieved Symptom Alert
The Provider Unrelieved Symptom Alert intervention sent an automatic symptom report to oncology providers (both physician and nurse) when the patient reported symptoms at a moderate to severe level (4-10 on a 0-10 scale). The oncology providers used their clinical judgement in terms of what they did with the information received. There was no prescribed response as part of the intervention.
Geen tussenkomst: Attentional Control Usual Care Group
Patients in the usual care group called the automated monitoring system daily to report presence, severity and distress (1-10 scale) on 9 symptoms and also measured symptom interference with daily activities, functional status, work attendance, and unscheduled provider visits, urgent care and emergency department visits, and unscheduled hospitalizations. The usual care group received equivalent contact time with the automated system including identical voice and assessment questions. Data were not available for clinical action and not reported to the oncology providers. On every call, usual care participants were reminded to call their oncology provider if they had symptom concerns, which is the usual practice in oncology settings to address unrelieved symptoms.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Patient reported symptom levels on a 0-10 scale
Tijdsspanne: patients report symptoms daily for the duration of the study, an expected average of 6 weeks
During daily automated calls, patients provided information about common chemotherapy symptoms.
patients report symptoms daily for the duration of the study, an expected average of 6 weeks

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Medical Encounters Telephone Interview
Tijdsspanne: participants will be followed for an expected average of 6 weeks
When a patient reports during their daily phone call with the automated symptom monitoring system that they had been in contact with a health care provider, the research staff would 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 by the system.
participants will be followed for an expected average of 6 weeks
Functional Status
Tijdsspanne: monthly for the duration of the study, participants will be followed for an expected average of 6 weeks
The SF-12 was administered monthly to measure functional status.
monthly for the duration of the study, participants will be followed for an expected average of 6 weeks
Work Attendance
Tijdsspanne: reported daily, participants will be followed for an expected average of 6 weeks
Patients who indicated at study enrollment that they planned to work during treatment answered a yes/no question during the automated symptom monitoring system call to report whether or not they worked the previous day.
reported daily, participants will be followed for an expected average of 6 weeks

Andere uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Patient End of Study Telephone Interview
Tijdsspanne: administered at the end of participation in the study, participants will be followed for an expected average of 6 weeks
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.
administered at the end of participation in the study, participants will be followed for an expected average of 6 weeks
Provider End of Study Interview
Tijdsspanne: Once, at the end of participation which is an expected average of 24 months
At the end of the study, participating providers were interviewed regarding the acceptability and use of the symptom alert reports and their suggestions for improvement.
Once, at the end of participation which is an expected average of 24 months

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

University of Utah

Medewerkers

National Cancer Institute (NCI)

Onderzoekers

  • Hoofdonderzoeker: Kathleen H Mooney, PhD, University of Utah

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 april 2001

Primaire voltooiing (Werkelijk)

1 maart 2004

Studie voltooiing (Werkelijk)

1 maart 2004

Studieregistratiedata

Eerst ingediend

22 oktober 2013

Eerst ingediend dat voldeed aan de QC-criteria

1 november 2013

Eerst geplaatst (Schatting)

8 november 2013

Updates van studierecords

Laatste update geplaatst (Werkelijk)

1 maart 2017

Laatste update ingediend die voldeed aan QC-criteria

28 februari 2017

Laatst geverifieerd

1 februari 2017

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Andere studie-ID-nummers

  • 7846-00
  • R01CA089474 (Subsidie/contract van de Amerikaanse NIH)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

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