Standardized Documentation and Assessments for Polycythemia Vera: A Quality Improvement Initiative (STANDARDIZE-PV)
STANDARDIZEd Documentation and Assessments for Polycythemia Vera (STANDARDIZE-PV): A Quality Improvement Initiative
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Polycythemia vera (PV) is a myeloproliferative neoplasm (MPN) characterized by unregulated clonal expansion of myeloid cells that primarily manifests with elevated red blood cells. Transformation to more aggressive, and potentially fatal diagnoses such as myelofibrosis or acute myeloid leukemia is observed in 5-15% at 15 years. Compared to an age- and sex-matched general population, patients with PV have a 3- to 13-fold higher risk of arterial and venous thromboembolic (TE) complications, which are the leading causes of premature morbidity and mortality. Other manifestations include microvascular disturbances (blurry vision, problems with concentration, paresthesia, headaches, palpitations), pruritus, and erythromelalgia. These symptoms may present with severity that do not correspond to conventional risk and may be harbingers of disease progression. Palpable splenomegaly and associated weight loss is also present in a third of patients at the time of PV diagnosis.
Cytoreductive therapies are now available and recommended for low and high-risk PV patients. As an example, ropeginterferon alfa-2b is a Federal Drug Administration-approved and commercially available cytoreductive agent since 2021 that has been shown to improve symptoms, reduce thrombotic risk, reduce risk of disease transformation, and death. Consequently, it is important to be able to recognize who requires cytoreduction with a comprehensive assessment. Despite this, prior studies demonstrate assessments are rarely comprehensive, and despite the availability of cytoreductive therapies that may reduce risk of thromboses and improve symptoms and spleen, there are delays in adoption of such agents in the real-world clinical setting.
Numerous studies have shown that disease-specific standardized progress note templates can be an effective means to incorporate knowledge into a clinician's workflow and enhance care quality without increasing documentation burden. In addition, Mass General Brigham has recently implemented a pharmacist-led management of ropeginterferon alfa-2b for PV patients.
Hence, the researchers propose to assess the feasibility, acceptability, and appropriateness of a PV-specific, EMR-based progress note template, in addition to the pharmacist-led ropeginterferon alfa-2b titration pathway, for clinicians across the institution.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Michelle Lee, MD
- Número de telefone: 617-882-6060
- E-mail: mlee37@mgb.org
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Filho
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Hematologists and medical oncologists within the Mass General Brigham network sites who treat at least one patient with PV in their outpatient clinic.
Exclusion Criteria:
- Clinicians who do not have an outpatient hematology or medical oncology clinic within Mass General Brigham.
- Clinicians who do not utilize the EPIC electronic medical record (EMR) System as their method of patient progress note documentation.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Cuidados de suporte
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: Standardized note with standard-of-care pharmacist support
Standardized progress note templates with opt-in option for standard-of-care pharmacist support of ropeginterferon alfa-2b titration
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Pilot intervention will include a standardized progress note for PV patient visits in addition to a standard-of-care opt-in for pharmacist-led titration for patients on ropeginterferon alfa-2b.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Feasibility of intervention
Prazo: 12 months
|
Number of participants that are eligible who enroll in this initiative and rating of feasibility by a single question on a 5-point Likert scale with score >3 indicating higher feasibility
|
12 months
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Acceptibility of intervention
Prazo: 12 months
|
Acceptability measured by a single question on a 5-point Likert scale with score >3 indicating higher acceptability.
|
12 months
|
|
Appropriateness of intervention
Prazo: 12 months
|
Appropriateness measured by a single question on a 5-point Likert scale with score >3 indicating higher appropriateness.
|
12 months
|
Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Rate of progress note use
Prazo: 12 months
|
Rate of progress note use per total number of PV patient visits over 12 month study period.
|
12 months
|
|
Rate of symptoms documentation
Prazo: 12 months
|
Rate of symptom documentation per total number of PV patient visits
|
12 months
|
|
Rate of cytoreductive therapy change or initiation
Prazo: 12 months
|
Rate of cytoreductive therapy change or initiation by clinician per total number of PV patients who are eligible for a therapy change or initiation.
|
12 months
|
|
Rate of referrals or second opinion consultations with a leukemia specialist
Prazo: 12 months
|
Rate of referrals or second opinion consultations with a leukemia specialist per total number of PV patients evaluated over study period
|
12 months
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 26-263
Plano para dados de participantes individuais (IPD)
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Descrição do plano IPD
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