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Improving the Quality of Life of Cancer Patients Through a Perioperative and Coordinated Nutrition and Physical Care Program. (PENDICOQ)

10. september 2021 oppdatert av: University Hospital, Strasbourg, France

Hospitalization, for cancer patients, exposes to a risk of undernutrition which has the effect of significantly increasing infections, pressure ulcers, muscle wasting, loss of autonomy, impaired function and delayed healing.

All of these factors contribute to increase the length of stay in hospital, thus lengthening the spiral of undernutrition, which has serious consequences for the patient welbeing, health establishments and public health.

Undernutrition has been the subject of many studies over the last twenty years, that outline that an adequate nutritional management exerts a direct effect on the reduction of comorbidities and duration of hospitalization.

However, there are periods, in the preoperative course of care, where nutritional and phisical care are not realized in the current clinical practice whereas they could be done, for example, between the diagnosis and the consultation of anesthesia, between the anesthesia consultation and the surgical procedure and the end of hospitalization of the patient.

Current management is usually limited to the period of hospitalization which tends to be reduced. This situation is reinforced by the absence of relays at home, dietary consultations being not reimbursed by French health insurance.

Moreover, a preliminary survey, conducted in 2012 during the pre-operative outpatient anesthesia consultation, shows that 26% of patients are already clinically malnourished, with 16.5 % of them who have lost more than 10% of their weight.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Then, the investigators hypothesize that the combination of perioperative nutrition and mobilization program coordinated andrealized by dieticians and physiotherapists, with the Nutrimus follow-up booklet, would improve the post-operative evolution of patients and reduce their postoperative comorbidities.

This management, initiated at the consultation of anesthesia, would include an accurate nutritional diagnosis, nutritional and physical support therapy to improve their nutritional and muscular status.

Studietype

Intervensjonell

Registrering (Forventet)

200

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Frankrike
      • Strasbourg, Frankrike, 67098
        • Rekruttering
        • Service de Médecine Interne et Nutrition, Hôpital de Hautepierre, Hôpitaux universitaires de Strasbourg
        • Hovedetterforsker:
          • Alain Pradignac, MD
        • Ta kontakt med:
        • Ta kontakt med:

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

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Patient ≥ 18 years old
  • Patient with Karnofsky index superior or equal to 60%.
  • Patient with cancer of the following digestive tract: peritoneal carcinoma, sarcoma, pancreas, rectum, esophagus, stomach diagnosed or under diagnosis
  • Patient admitted for a scheduled surgery at least 10 days after a preoperative consultation
  • Patient affiliated to a social health insurance scheme
  • Patient having dated and signed an informed consent
  • Patient having been informed of the results of the prior medical examination

Exclusion Criteria:

  • Inhospital patients
  • Patient admitted in emergency
  • Impossibility of giving the patient information (alteration of patient's cognitive function)
  • Illiteracy or dyscalculia
  • Patients protected (guardianship, curatorship, safeguard of justice)
  • Pregnancy, breastfeeding
  • Subject in exclusion period (determined by a previous or ongoing study),
  • Patient included in another ongoing clinical trial
  • Patient with neuro-endocrine cancer
  • Patient reoperated for the same pathology

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Experimental group
nutritional and functional management coordinated by dieticians and physiotherapists, with adapted nutritional and physical advice and support, realized with the use of Nutrimus booklet in order to facilitate coordination and delivration of cares proposed to the patients
Annen: Dietary intervention
Nutritional status assessment Presentation of the Nutrimus booklet by the coordinating dietitian Establishment or adaptation of a nutritional support (prescription of nutritional supplements if necessary). Delivery and explanation of the preoperative nutritional counseling support
Annen: Intensify physiotherapist intervention
Respiratory capacity Functional capacity Tips adapted for physical activity and strengthening or maintenance of muscle mass Presentation of respiratory physiotherapy exercises to prevent postoperative bronchial congestion Nutrition and physical mobilization tips with the Nutrimus booklet
Aktiv komparator: Control group
usual preoperative advice for patients who undergoing surgical procedure concerning nutritional cares and physical activity
Annen: Dietary advice
Nutritional status assessment Explanation of standard nutritional advices with an written explanation sheet
Annen: Physiotherapist intervention
Respiratory capacity Functional capacity

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Variation of the Medical Outcome Study Short Form 36 score
Tidsramme: Change in score at 30 days before surgery and 1 Day before hospital discharge
Use of a scale for quality of life
Change in score at 30 days before surgery and 1 Day before hospital discharge

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Sarcopenia index measurement
Tidsramme: 30 days before surgery
Measure from routine preoperative Computerized Tomography scan
30 days before surgery
Satisfaction score of the Nutrimus tool
Tidsramme: 6 months postoperative
Use of a questionnaire
6 months postoperative
Ease of use of the Nutrimus tool
Tidsramme: 6 months postoperative
Use of a questionnaire
6 months postoperative
Measurement of the Medical Outcome Study Short Form 36 score
Tidsramme: Change in score at 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Use of a scale for quality of life
Change in score at 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Evaluation of nutritional parameters
Tidsramme: Change in values measures at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Use of a notebook
Change in values measures at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Evaluation of respiratory and functional capacities
Tidsramme: Change in measures at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Change in measures at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Pain assessment
Tidsramme: Change in score at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Use of a visual analogue scale Measure of score from 0 to 10
Change in score at 30 days to 10 days, 1 day before surgery, 1 day before the end of hospitalization, 1 Month, 3 Months and 6 Months post hospitalization
Length hospitalization
Tidsramme: Duration (in days) of patient's hospitalization
Length (in days) between hospital admission and discharge
Duration (in days) of patient's hospitalization

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University Hospital, Strasbourg, France

Etterforskere

  • Hovedetterforsker: Alain PARDIGNAC, Strasbourg Universitary hospitals

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 (Faktiske)

29. januar 2019

Primær fullføring (Forventet)

28. april 2024

Studiet fullført (Forventet)

28. april 2024

Datoer for studieregistrering

Først innsendt

11. juli 2018

Først innsendt som oppfylte QC-kriteriene

12. september 2018

Først lagt ut (Faktiske)

13. september 2018

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

13. september 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

10. september 2021

Sist bekreftet

1. september 2021

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 6117

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

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Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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