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Cancer & Chemotherapy Symptom Management Using an Automated Telephone Reporting System

28 de fevereiro de 2017 atualizado por: 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.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Real)

250

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Cuidados de suporte
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
Outro: 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.
Sem intervenção: 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.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Patient reported symptom levels on a 0-10 scale
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Medical Encounters Telephone Interview
Prazo: 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
Prazo: 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
Prazo: 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

Outras medidas de resultado

Medida de resultado
Descrição da medida
Prazo
Patient End of Study Telephone Interview
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

University of Utah

Colaboradores

National Cancer Institute (NCI)

Investigadores

  • Investigador principal: Kathleen H Mooney, PhD, University of Utah

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de abril de 2001

Conclusão Primária (Real)

1 de março de 2004

Conclusão do estudo (Real)

1 de março de 2004

Datas de inscrição no estudo

Enviado pela primeira vez

22 de outubro de 2013

Enviado pela primeira vez que atendeu aos critérios de CQ

1 de novembro de 2013

Primeira postagem (Estimativa)

8 de novembro de 2013

Atualizações de registro de estudo

Última Atualização Postada (Real)

1 de março de 2017

Última atualização enviada que atendeu aos critérios de controle de qualidade

28 de fevereiro de 2017

Última verificação

1 de fevereiro de 2017

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Outros números de identificação do estudo

  • 7846-00
  • R01CA089474 (Concessão/Contrato do NIH dos EUA)

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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