LCCM-Control: Symptom Management, Quality of Life and Satisfaction With Care for Advanced Stage Cancers - Control Arm
Study Details
Study Description
Brief Summary
Symptom Management, Quality of Life and Satisfaction with Care for Advanced Stage Cancers is the first part of a two part study (The Lancaster Cancer Care Model (LCCM) - Non-Concurrent Control Study). The primary aim of the study is to compare the proportion of advanced cancer patients who have a hospitalization or emergency department visit in the last 6 months of life before and after implementation of a new care model that provides more comprehensive symptom management and supportive care, including earlier referral to palliative care. The secondary comparative aim is to assess measures of quality of life and satisfaction in both groups. This current study is to collect data on the control group only. After system redesign, we will open an intervention arm study to collect data after implementation of the new care model (about 18-24 months from start of control phase).
Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
Symptom Management, Quality of Life and Satisfaction with Care for Advanced Stage Cancers is the first part of a two part study (The Lancaster Cancer Care Model (LCCM) - Non-Concurrent Control Study) that was submitted to the National Cancer Institute (NCI) for funding. A decision on funding the full study should be forthcoming in the early part of 2015. The primary aim of the study is to compare the proportion of advanced cancer patients who have a hospitalization or emergency department visit in the last 6 months of life before and after implementation of a new care model that provides more comprehensive symptom management and supportive care, including earlier referral to palliative care. The secondary comparative aim is to assess measures of quality of life and satisfaction in both groups. To accomplish the aims of the study by the end of the funding period, we propose to begin data collection in advance of a funding decision. Should the study not receive funding, the data collected will be used to inform decisions regarding other funding applications and/or implementation of program changes at the Ann B. Barshinger Cancer Institute. Data collection does not represent more than minimal risk for the patients enrolled.
This protocol is for the first phase of the study, which is the enrollment and collection of data on the control group, to serve as the baseline for comparison regarding hospitalizations, ED visits, quality of life, and patient and family satisfaction. To achieve sufficient number of subjects and observed deaths in the control group, we are targeting the start of enrollment and data collection in this group during the third quarter of 2014. If the project is funded, the intervention and enrollment in the intervention group are targeted to start in the second quarter of 2016. Background and study aims are presented for the entire project to provide context, but the intent of this application is only for approval of the enrollment and data collection on the control subjects (which contributes to aims 2 and 3 of the larger project). A second protocol would be presented for review and approval at the start of the intervention if the project funding is granted.
In phase one of the project, subjects would be approached and consented at the point of a determination/diagnosis of advanced cancer and followed until the end of life or the start of the intervention period in the 2nd quarter of 2016 (whichever comes first) per protocol.
This current study is to collect data on the control group only. After system redesign, we will open an intervention arm study to collect data after implementation of the new care model (about 18-24 months from start of control phase).
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Non-concurrent control group A group of advanced cancer patients who received care at our Center before implementation of the LCCM model. They will receive current standard of care. This current study is to collect data on the control group only. After system redesign, we will open an intervention arm study to collect data after implementation of the new care model (about 18-24 months from start of control phase). |
Other: Standard of care
Patients will be cared for using current standard of care preceding the design and implementation of the LCCM model of care.
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Outcome Measures
Primary Outcome Measures
- Frequency of patients' ED visits and hospitalizations [Collected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months]
All cause: ED admission treat and release, ED admission to inpatient visit and direct inpatient admission
Secondary Outcome Measures
- Patient quality of life [Collected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months]
Assessed with FACT-G (Functional Assessment of Cancer-General measure)
- Patient satisfaction [Collected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months]
Assessed with FAMCARE-2 (patient and family satisfaction with care)
- Caregiver burden [Collected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months]
Assessed with BASC (Brief Assessment Scale for Caregivers) Caregiver Burden
- Caregiver satisfaction [Collected at baseline and every 2 months from enrollment until death from any cause or assessed up to 18 months]
Assessed with FAMCARE-2 (patient and family satisfaction with care)
- Patient symptoms [Collected at baseline and every outpatient oncology clinic visit from enrollment until death from any cause or assessed up to 18 months]
Assessed with the ESAS-R (Edmonton Symptom Assessment System Revised) and ECOG (Eastern Cooperative Oncology Group) performance status
Eligibility Criteria
Criteria
Inclusion Criteria:
- Newly diagnosed with a solid tumor-type cancer that is considered either advanced and unresectable or metastatic
Exclusion Criteria:
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Non-English speaking
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Age < 18
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Lancaster General Ann B. Barshinger Cancer Institute | Lancaster | Pennsylvania | United States | 17604 |
Sponsors and Collaborators
- Lancaster General Hospital
Investigators
- Study Director: Shanthi Sivendran, MD, MSCR, Lancaster General Ann B. Barshinger Cancer Institute
- Study Director: Randy Oyer, MD, Lancaster General Ann B. Barshinger Cancer Institute
- Principal Investigator: Nik Buescher, Lancaster General Ann B. Barshinger Cancer Institute
- Principal Investigator: Joan Harrold, MD, Palliative Medicine Consultants
- Principal Investigator: Barbara Martin, PhD, Lancaster General Research Institute
- Principal Investigator: Kristina Newport, MD, Palliative Medicine Consultants
- Principal Investigator: Michael Horst, PhD, Lancaster General Research Institute
Study Documents (Full-Text)
None provided.More Information
Additional Information:
- Cancer Facts and Figures 2014. (n.d.). Retrieved May 21, 2014, from http://www.cancer.org/acs/groups/content/@research/documents/webcontent/acspc-042151.pdf
- The Dartmouth Atlas of Health Care. (2010). Retrieved May 21, 2014, from www.darthmouth.org/keyissues/issues.aspx?con=294
- National Community Cancer Centers Program Pilot Fact Sheet, 2007-2010. (n.d.) Retrieved June 16, 2014 from http://ncccp.cancer.gov/Media/FactSheet.htm
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