Cancer Symptom Monitoring Telephone System With Nurse Practitioner (NP) Follow up

Cancer Clinical Trial

Official title:

Telephone Linked Care: An IT Enabled Integrated System for Cancer Symptom Relief

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01973946
• Other study ID #: 17472
• Secondary ID: 5R01CA120558
• Status: Completed
• Phase: N/A
• First received: October 22, 2013
• Last updated: February 28, 2017
• Start date: September 2007
• Est. completion date: April 2012

Study information

• Verified date: February 2017
• Source: University of Utah
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this prospective trial is to test a daily telephone based automated symptom monitoring and response system to track and further treat unrelieved symptoms for patients living at home during chemotherapy treatment as compared with usual care which consists of patients calling their oncology provider for symptom concerns.

Description:

The purpose of this prospective trial is to test a daily telephone based automated symptom monitoring and response system to track and further treat unrelieved symptoms for patients living at home during chemotherapy treatment as compared with usual care which consists of patients calling their oncology provider for symptom concerns. For the intervention group, the monitoring system is paired with automated delivery of self-care suggestions tailored to the specific symptom profile the patient reported and also automatically 'alerts' the study oncology nurse practitioner about unrelieved symptoms. The nurse practitioner, utilizing national evidence based symptom guidelines for symptoms at moderate to severe levels calls the patient and further assesses and intensifies symptom treatment. The usual care group called the system daily and reported similar data but did not receive self-care coaching or notification of unrelieved symptoms to the study nurse practitioner. On every call, the usual care group was told to follow the standard procedure of calling their oncology providers for symptom concerns. The specific aims of the study are to test whether the symptom monitoring intervention reduces presence, severity and distress of 11 symptoms. The symptoms monitored in the project were nausea/vomiting, pain, sore mouth, numbness & tingling, diarrhea, trouble thinking, trouble sleeping, changes in appearance, depressed mood, anxiety, and fatigue. Secondary outcomes tested whether the intervention improved functional performance and decreased interference with activity when compared with the usual care attentional control group. Other aims compare self care strategies utilized and their perceived effectiveness and document patient satisfaction with the monitoring system.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 358
• Est. completion date: April 2012
• Est. primary completion date: April 2012
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adult (age 18 or over)

• Have a histological diagnosis of cancer

• a life expectancy of at least 3 months and cognitively able to participate

• Beginning a new course of chemotherapy that is planned for a minimum of 3 cycles;

• care is under the direction of one of the 8 designated provider teams;

• English speaking;

• has access to a telephone on a daily basis and is able to use the phone unassisted as verified by the study staff during participant orientation.

Exclusion Criteria:

• patients who are receiving concurrent radiation therapy (as they would have daily contact with the health care system);

• patients who see the provider team for recommendation of a chemotherapy regimen but treatment is then administered at a different site by other providers.

• Patients receiving therapy agents that result in a drug related fever or therapy agents that are not anticipated to cause any of the 11 symptoms.

Related Conditions & MeSH terms

• Cancer

Intervention

Other:
• Symptom Alert and Coaching
Patients heard self-care messages when they reported a symptom was present. The Symptom Alert and Coaching intervention alerted study nurse practitioners of unresolved symptoms daily. The NPs responded to all alerts generated by patients and using evidence based guidelines, called patients to further assess and to intensify symptom treatment.

Locations

Country	Name	City	State
United States	Vanderbilt-Ingram Cancer Center	Nashville	Tennessee
United States	University of Utah Huntsman Cancer Institute	Salt Lake City	Utah

Sponsors (2)

Lead Sponsor	Collaborator
University of Utah	National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Patient End of Study Telephone Interview	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 once, at the end of the patients' participation in the study which was following an entire new course of chemotherapy or 6 months whichever occurred first.
Other	Evaluation of automated and other self care strategies used and their effectiveness	The symptom monitoring system tracked when an intervention participant heard a self care strategy during the course of the week. Each week patients would report on how helpful (1-10 scale) the automated self care measures were for the specific symptoms.	Weekly for an entire new course of chemotherapy or 6 months whichever occurred first.
Primary	Patient reported symptom levels	During daily automated calls, patients provided information about common chemotherapy symptoms on a 0-10 scale.	Daily patient reports of symptom levels were made for an entire new course of chemotherapy or 6 months whichever occurred first.
Secondary	Medical Encounters Telephone Interview	Each week patients reported during their daily phone calls whether or not they had been in contact with a health care provider, were seen in an emergency department or urgent care facility, or had an unscheduled hospitalization. If they reported they did have a medical encounter, the research staff would call and 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.	Each week patients reported during the daily symptom monitoring call whether they had a medical encounter for an entire new course of chemotherapy or 6 months whichever occurred first.
Secondary	Patient reported symptom related interference with daily activities	This is a one item question asked daily during the symptom monitoring call about the level of interference their symptoms had on their daily activities (0-10 scale).	Reported daily for an entire new course of chemotherapy or 6 months whichever occurred first.
Secondary	SF-36 Functional Status	Functional status was measured monthly using the SF-36.	Monthly for an entire new course of chemotherapy or 6 months whichever occurred first.
Secondary	Work interference	For patients who indicated they worked during their treatment, the system asked daily if they missed work if it was a regular workday.	Reported daily for an entire new course of chemotherapy or 6 months whichever occurred first.
Secondary	Work Limitations Questionnaire	The 25 item patient-reported Work Limitations Questionnaire was used to measure work performance.	Monthly for an entire new course of chemotherapy or 6 months whichever occurred first.