Pilot Randomized-controlled Trial of Integrated Palliative and Nephrology Care Versus Usual Nephrology Care.
1. oktober 2021 oppdatert av: NYU Langone Health
A Pilot Randomized-Controlled Study Of The Impact Of Integrated Palliative And Nephrology Care Versus Usual Nephrology Care On Symptom Burden, Quality Of Life And Advance Care Planning In Patients With Chronic Kidney Disease Stage V Not On Dialysis
The objective of this application is to conduct a pilot study testing the impact of integrated nephrology and palliative care versus standard nephrology care on patient-reported outcomes.
This study is a preliminary study designed to determine feasibility of a palliative care study inclusive of kidney disease patients and to look for trends in impact over a 12-week follow-up period.
Measurements will be taken at time one (time of enrollment) and time two (12 weeks).
Our central hypothesis is that integration of palliative care with standard nephrology care in the ambulatory care of patients with a glomerular filtration rate (eGFR) ≤15ml/min/1.73m2
will trend towards improved symptom control, quality of life, and increased documentation of advance care planning when compared to usual nephrology care.
We expect 10-15 patients per arm.
Studieoversikt
Status
Fullført
Forhold
Intervensjon / Behandling
Studietype
Intervensjonell
Registrering (Faktiske)
45
Fase
- Tidlig fase 1
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
New York
-
New York, New York, Forente stater, 10016
- NYU Langone Health
-
-
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:
In order to be eligible to participate in this study, an individual must meet all of the following criteria:
- Age ≥18
- Fluent English speaker
- eGFR≤15 mL/min/1.73m2 (diagnosis of CKD stage V)
- Able to give consent
- Must be followed by a faculty group practice nephrologist
Exclusion Criteria:
An individual who meets any of the following criteria will be excluded from participation in this study:
- Diagnosis of dementia
- Non-English speaker
- Have been seen by a palliative care provider prior to study entry
- Pregnant women
- On dialysis or have received a kidney transplant
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: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: Arm 1
Intervention
|
Monthly ambulatory care visits with the kidney palliative care team in the intervention group for three months. The intervention in this study is addition of a palliative care team to the care team of the subject. This intervention will not change or impact their regular nephrology care. The subjects in the intervention arm will be seen by the palliative care team three times over the 12-week study period (once per month).The intervention will be delivered by a physician trained in both palliative care and nephrology, the PI of the study. |
|
Annen: Arm 2
Standard Care
|
Standard nephrology care
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in IPOS-Renal symptom assessment score
Tidsramme: Baseline, week 12
|
IPOS-Renal is a short measure (11 questions), combining the most common symptoms renal patients experience plus additional items from IPOS on concerns beyond symptoms, such as information needs, practical issues, family anxiety.
The total score reflects symptom burden and can range from zero to 68, where 0 is least symptom burden and 68 is highest symptom burden.
|
Baseline, week 12
|
|
Change in KDQOL-SF 36 Quality of Life Scores
Tidsramme: Baseline, week 12
|
The KDQOL-36 has five scales, including two generic HRQOL scales from the SF-12 version 1 (12 items total) and three kidney-specific scales (24 items total).
The SF-12 PCS and MCS are scored on a T-score metric (mean=50, SD=10, in the United States general population), with higher scores indicating better HRQOL.
|
Baseline, week 12
|
|
Difference between the number of documented advanced care planning between arms
Tidsramme: Week 12
|
advanced care planning = health care proxy, Medical Order for Life Sustaining Treatment [MOLST], or a Do Not Resituate form
|
Week 12
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
retention patients at the end of the study
Tidsramme: 12 weeks
|
12 weeks
|
|
|
percent of returned clinical surveys (IPOS-R and KDQOL-SF 36
Tidsramme: 12 weeks
|
12 weeks
|
|
|
patient satisfaction as rated on the Press Ganey Survey
Tidsramme: 12 weeks
|
Measure satisfaction on a five point scale where "5" is the Top Score.
|
12 weeks
|
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in IPOS-Renal symptom assessment score over time in intervention arm
Tidsramme: Baseline, 6 weeks, 12 weeks
|
Exploratory end-points include change in symptom burden over time in the intervention arm.
These subjects are expected to have three visits with symptom surveys filled out at each visit.
We hypothesize that symptom burden will improve over time.
|
Baseline, 6 weeks, 12 weeks
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
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)
12. juli 2020
Primær fullføring (Faktiske)
26. april 2021
Studiet fullført (Faktiske)
26. april 2021
Datoer for studieregistrering
Først innsendt
18. august 2020
Først innsendt som oppfylte QC-kriteriene
18. august 2020
Først lagt ut (Faktiske)
20. august 2020
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
5. oktober 2021
Siste oppdatering sendt inn som oppfylte QC-kriteriene
1. oktober 2021
Sist bekreftet
1. oktober 2021
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 18-01259
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
JA
IPD-planbeskrivelse
The de-identified participant data from the final research dataset used in the published manuscript will be shared upon reasonable request beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research provided the investigator who proposes to use the data executes a data use agreement with NYU Langone Health.
Requests may be directed to the PI.
The protocol and statistical analysis plan will be made available on Clinicaltrials.gov
only as required by federal regulation or as a condition of awards and agreements supporting the research.
IPD-deling Støtteinformasjonstype
- STUDY_PROTOCOL
- SEVJE
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Nei
Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
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. .