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Developing and Testing the Effectiveness of Smart Healthcare Assisted Individualized Symptom Management Education and Home-based Exercise on Frailty, Treatment-related Adverse Events and Quality of Life in Advanced Gastric Cancer Patients Receiving Immunotherapy

23 lipca 2026 zaktualizowane przez: Taipei Veterans General Hospital, Taiwan

The goal of this randomized controlled intervention is to develop and evaluate the effectiveness of the nurse-led with AI chatbot Individualized Symptom Management Education and Home-based Exercise (AI-ISME&HE) based on The Theory of Symptom Self-Management (TSSM) on frailty, self-efficacy in cancer care, trAE, and quality of life in advanced gastric cancer patients receiving immunotherapy. The main questions it aims to answer are:

  • Can AI-ISME&HE reduces frailty in advanced gastric cancer patients receiving immunotherapy?
  • Can AI-ISME&HE increases quality of life in advanced gastric cancer patients receiving immunotherapy?
  • Can AI-ISME&HE increases self-efficacy in advanced gastric cancer patients receiving immunotherapy?
  • Can AI-ISME&HE reduces all-caused death in advanced gastric cancer patients receiving immunotherapy within two years? Researchers will compare usual routine care to see if AI-ISME&HE can reduce frailty, all-caused death and increase quality of life and self-efficacy.

Participants will not be blinded, but the outcome evaluator will be blinded. The participants will be asked to complete three tasks for 12 weeks:

  • Self-reporting treatment-related adverse events
  • Interacting with AI-ISME&HE for seeking information related to self-management educational materials, including symptom management with the most reported trAEs and prevention from frailty
  • ViviFrail-based exercise

Przegląd badań

Status

Jeszcze nie rekrutacja

Interwencja / Leczenie

Typ studiów

Interwencyjne

Zapisy (Szacowany)

110

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria:

  1. age ≥18 years
  2. diagnosed as AGC (TNM: T2~T4, N>0, Any M, Stage: III~IV, or unresectable GC)
  3. scheduled to receive the first cycle of immunotherapy
  4. willingness to provide written informed consent after receiving a full explanation of the study

Exclusion Criteria:

  1. a diagnosis of another type of cancer within the past five years
  2. inability to communicate clearly
  3. a diagnosis of dementia
  4. acute pulmonary embolism
  5. acute myocardial infarction
  6. extremity bone fracture within the past three months
  7. bone metastasis

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Inny
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Pojedynczy

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Intervention
AI-ISME&HE intervention group
  • Self-reporting treatment-related adverse events
  • Interacting with AI-ISME&HE for seeking information related to self-management educational materials, including symptom management with the most reported trAEs and prevention from frailty
  • ViviFrail-based exercise
Brak interwencji: Control
Usual routine care

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Level of Frailty Assessed by The Short Physical Performance Battery (SPPB)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The SPPB score from 0-12 points, with 10-12 indicating robust, 7-9 indicating prefrail, and 4-6 indicating frail. It has good reliability (ICC range from 0.82-0.92) and validity.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Frailty Assessed by Comprehensive Geriatrics Assessment
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.

A total of 8 domains were used to comprehensively assess frailty in cancer patients: Functional status, Comorbidity, Nutrition, Polypharmacy, Social support, Cognition, and Mood. 0 abnormal domains indicate robust, any 1 abnormal indicates pre-frail, and 2 or more abnormality indicate frailty. Each domain can be assessed by different tools. In this study, we chose the tools according as follows:

  1. Functional status: Grip strength.
  2. Comorbidity: Charlson Comorbidity Index by ICD-10 and exclude age and cancer diagnosis. CCI scores > 3 indicates multimorbidity.
  3. Cognition: the Montreal Cognitive Assessment (MoCA).
  4. Mood: Geriatric Patient Health Questionnaire-9 (PHQ-9).
  5. Nutritional status: Mini Nutritional Assessment (MNA).
  6. Polypharmacy: number of daily medications.
  7. Social support: live alone or with family.
  8. Falls history: the falling times in the past year.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Frailty Assessed by Geriatric 8 (G8)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The G8 score from 0-17 points, with score ≤14 indicating frailty. It has good sensitivity (86.9%) in cancer patients
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Frailty Assessed by Taiwan Cancer Frailty Tool (TCFT)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The TCFT score from 0-5 points, with score >0 indicating frailty. It has good ROC values of 0.857 in cancer patients
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Score of Quality of Life Assessed by The Functional Assessment of Cancer Therapy - General - 7 Item Version (FACT-G7)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
It includes 7 items and compromised physical well-being (3 items), emotional well-being (1 items), and functional well-being (3 items). The score of each item is from 0 (not at all) to 5 (very much), and the total score ranging from 0 to 28, with a higher score indicating better quality of life.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Self-efficacy Assessed by The Modified Cancer Behavior Inventory (CBI)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
It is a 0-10 Likert-type scale, where 0 indicates no confidence at all and 10 indicates fully confidence.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
All Cause Mortality After 2 Year Follow-up
Ramy czasowe: Record patient's survival status at baseline, 1 year after baseline, and 2 year after baseline.
The survival status of the patients will be followed by medical record.
Record patient's survival status at baseline, 1 year after baseline, and 2 year after baseline.
Level of Symptom Severity Assessed by The Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The 14 symptoms include fatigue, headache, shortness of breath, nausea/vomiting, rash, diarrhea, decreased appetite, numbness/tingling, general pain, blurred vision, constipation, abdominal pain, itching, and dizziness. Symptoms are assessed by using five-point Likert-type scale to rate symptom frequency (never, rarely, occasionally, frequently, almost constantly), severity (none, mild, moderate, severe, very severe), and interference (not at all, a little bit, somewhat, quite a bit, very much) in the past 7 days. It can composite grading based on an algorithm into grade 0 to 3.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Nutrition Status Assessed by The Mini Nutritional Assessment Short Form (MNA-SF)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
It includes 6 items relating to food intake in the past three months, weight loss in the past three months, physical activity, stress, dementia or depression, and body mass index (BMI). The total score ranges from 0-14, with 12-14 representing well, 8-11 representing at risk, and 0-7 representing malnutrition.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Cognitive Function Assessed by The Montreal Cognitive Assessment (MoCA)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
The scale consists of 12 items with a total score ranging from 0 to 30, assessing cognitive function across eight domains, including visuospatial construction, executive function, naming, memory, attention, language, abstraction, delayed recall, and orientation. A score of 24 below indicates cognitive impairment.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Depression Assessed by The Patient Health Questionnaire-9 (PHQ-9)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
PHQ-9 is a depression muddle from the complete PHQ, including nine DSM-IV criteria for depression, each item scores from 0-3, with a total score range from 0-27. A higher score indicates higher severity of depression, with a score 0-4 as none, 5-9 as mild, and ≥ 10 as moderate-severe depression.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Level of Physical Function Assessed by Grip Strength (GS)
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
GS will be assessed by JAMAR hydraulic dynamometer, which show good reliability. The participants will be asked to sit in the neutral position with their elbows flexed at 90° and resting at their sides. Next, they need to squeeze the handle of the dynamometer for 3-5 seconds as hard as possible for 3 trials on dominant hand with a rest of 60 seconds. The average and the maximum of the grip strength (kg) will be recorded. Female with GS ≤ 16 kg and male ≤ 26.7 kg refer to frailty.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Changes of Body Composition Assessed by Body Composition Machine
Ramy czasowe: Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.
Body composition will be examined by ACCUNIQ BC300 which is a lightweight, foldable professional body composition analyzer that utilizes bioelectrical impedance analysis (BIA) technology. Through eight electrodes and three different frequencies (5, 50, 250 kHz), it performs full-body and segmented (arms, legs, torso) measurements, quickly providing detailed data such as body fat, muscle mass, and water content with high accuracy within 5 minutes.
Changes from baseline, 12 weeks after baseline, and 24 weeks after baseline.

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Śledczy

  • Krzesło do nauki: I-Wen Chang, PhD, Department of Nursing, Taipei Veterans General Hospital

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

21 lipca 2026

Zakończenie podstawowe (Szacowany)

31 lipca 2029

Ukończenie studiów (Szacowany)

31 lipca 2030

Daty rejestracji na studia

Pierwszy przesłany

23 lipca 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

23 lipca 2026

Pierwszy wysłany (Rzeczywisty)

29 lipca 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

29 lipca 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

23 lipca 2026

Ostatnia weryfikacja

1 lipca 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • 2026-02-009CC
  • 115-2314-B-A49 -016 -MY3 (Inny numer grantu/finansowania: National Science and Technology Council)

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

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