Does Outpatient Palliative Care Improve Patient-centered Outcomes in Parkinson's Disease?
22. januar 2020 oppdatert av: University of Colorado, Denver
The purpose of this study is to improve outcomes for persons living with Parkinson's Disease (PD) and their family caregivers.
The investigators hypothesize that outpatient interdisciplinary palliative care will improve patient-centered outcomes for PD patients at high-risk for poor outcomes.
Studieoversikt
Status
Fullført
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Palliative care is an approach to caring for individuals with life-threatening illnesses that addresses potential causes of suffering including physical symptoms such as pain, psychiatric symptoms such as depression, psychosocial issues and spiritual needs.
Palliative care approaches have been successfully applied to improve patient-centered outcomes in cancer as well as several chronic progressive illnesses including heart failure and pulmonary disease.
To date there have been minimal attempts to apply these principles to PD although preliminary evidence suggests that PD patients have significant unmet needs under current models of care which may be amenable through a palliative care model.
This study will provide critical information to forward this field including data on the comparative effectiveness of outpatient palliative care for PD versus current standards of care; effects of this intervention on cost and service utilization; and the characteristics of patients most likely to benefit from such an approach and the specific services most needed by PD patients and their caregivers.
Studietype
Intervensjonell
Registrering (Faktiske)
210
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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Alberta
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Edmonton, Alberta, Canada, T6G 2E1
- University of Alberta Canada
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-
-
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California
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San Francisco, California, Forente stater, 94143
- University of California, San Francisco
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Colorado
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Aurora, Colorado, Forente stater, 80045
- University Of Colorado Hospital
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
40 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- Fluent in English
- UK Brain Bank criteria for diagnosis of probable PD or Multiple Systems Atrophy (MSA) or Corticobasal Degeneration (CBD) or Progressive Supranuclear Palsy (PSP) or Lewy Body Dementia (LBD)
- At high risk for poor outcomes as identified by the Palliative Care Needs Assessment Tool (PC-NAT)
Exclusion Criteria:
- Immediate and urgent palliative care needs
Unable or unwilling to commit to study procedures including;
- randomization,
- study visits or
- the addition of a neurologist to their care team
- Presence of additional chronic medical illnesses which may require palliative services
- Already receiving palliative care and/or hospice services.
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Annen: Standard of Care
Usual care as in including both a Primary Care Physician (PCP) and neurologist.
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Usual care defined as including both a PCP and neurologist
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Aktiv komparator: Interdisciplinary outpatient palliative care
Usual care augmented by an outpatient interdisciplinary palliative care team.
|
Interdisciplinary outpatient palliative care is an approach to caring for individuals with life-threatening illnesses that addresses potential causes of suffering including physical symptoms such as pain, psychiatric symptoms such as depression, psychosocial issues and spiritual needs.
Palliative care approaches have been successfully applied to improve patient-centered outcomes in cancer as well as several chronic progressive illnesses including heart failure and pulmonary disease.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Changes in the Subjects Quality of Life (QOL)
Tidsramme: 0 to 6 months
|
The QOL-AD (Quality of Life in Alzheimer's Disease) survey will be used to measure the differences in the quality of life between groups.Higher numbers indicate better outcomes.
The scale ranges from 4 to 52.
|
0 to 6 months
|
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Changes in Caregiver Distress
Tidsramme: 0 to 6 months
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The Zarit Caregiver Burden Interview Form (ZBI) will be used to measure differences in Caregiver Distress between groups.
Higher scores indicate worse outcomes.
Scale ranges from 0 to 48.
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0 to 6 months
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Changes in Patient Anxiety
Tidsramme: 0 to 6 months
|
The Hospital Anxiety and Depression Scale (HADS) will be used to quantify changes in patient anxiety.
Higher numbers indicate worse outcomes.
Scale ranges from 0 to 21.
|
0 to 6 months
|
|
Changes in Patient Depression
Tidsramme: 0 to 6 months
|
The Hospital Anxiety and Depression Scale (HADS) will be used to quantify changes in patient depression.
Higher numbers indicate worse outcomes.
Scale ranges from 0 to 21.
|
0 to 6 months
|
|
Changes in Caregiver Anxiety
Tidsramme: 0 to 6 months
|
The Hospital Anxiety and Depression Scale (HADS) will be used to quantify changes in caregiver anxiety.
Higher numbers indicate worse outcomes.
Scale ranges from 0 to 21.
|
0 to 6 months
|
|
Changes in Caregiver Depression
Tidsramme: 0 to 6 months
|
The Hospital Anxiety and Depression Scale (HADS) will be used to quantify changes in caregiver depression.
Higher numbers indicate worse outcomes.
Scale ranges from 0 to 21.
|
0 to 6 months
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Etterforskere
- Hovedetterforsker: Benzi Kluger, University of Colorado - Anschutz Medical Campus
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Macchi ZA, Miyasaki J, Katz M, Galifianakis N, Sillau S, Kluger BM. Prevalence and Cumulative Incidence of Caregiver-Reported Aggression in Advanced Parkinson Disease and Related Disorders. Neurol Clin Pract. 2021 Dec;11(6):e826-e833. doi: 10.1212/CPJ.0000000000001110.
- Koljack CE, Miyasaki J, Prizer LP, Katz M, Galifianakis N, Sillau SH, Kluger BM. Predictors of Spiritual Well-Being in Family Caregivers for Individuals with Parkinson's Disease. J Palliat Med. 2022 Apr;25(4):606-613. doi: 10.1089/jpm.2020.0797. Epub 2021 Nov 24.
- Kluger BM, Miyasaki J, Katz M, Galifianakis N, Hall K, Pantilat S, Khan R, Friedman C, Cernik W, Goto Y, Long J, Fairclough D, Sillau S, Kutner JS. Comparison of Integrated Outpatient Palliative Care With Standard Care in Patients With Parkinson Disease and Related Disorders: A Randomized Clinical Trial. JAMA Neurol. 2020 May 1;77(5):551-560. doi: 10.1001/jamaneurol.2019.4992.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart
1. oktober 2015
Primær fullføring (Faktiske)
20. september 2018
Studiet fullført (Faktiske)
30. september 2019
Datoer for studieregistrering
Først innsendt
20. august 2015
Først innsendt som oppfylte QC-kriteriene
26. august 2015
Først lagt ut (Anslag)
27. august 2015
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
31. januar 2020
Siste oppdatering sendt inn som oppfylte QC-kriteriene
22. januar 2020
Sist bekreftet
1. januar 2019
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 15-0814
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .