Idiopathic Pulmonary Fibrosis Clinical Trial
— PALIFOfficial title:
Impact of a Systematic Palliative Care on Quality of Life, in Advanced Idiopathic Pulmonary Fibrosis (IPF). A Randomized Multi-center Trial.
Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a survival median
between 2 and 4 years which leads to a profound alteration of the quality of life.
In thoracic oncology, the systematic and early intervention of a palliative care team result
in an improvement of quality of life for patients.
In the princeps study published in 2010, the early intervention of a dedicated palliative
care team was compared to standard care in a randomized trial of 150 patients and shows a
significant improvement : (i) of quality of life (main objective), (ii) of depression scores
and even overall survival (11.6 months vs. 8.9 months, P = 0.02), (iii) a benefit in terms of
understanding the diagnosis and therapeutic goals (3), (iv) diminution of adapted
hospitalization in end of life (in emergency or not).
Considering some analogy points between IPF and advanced lung cancer (prognosis, respiratory
symptom, psychological burden), it seemed reasonable to assume that the joint systematic
intervention of chest physician and palliative care team may provide a significant benefit in
terms of quality of life for patients with severe IPF.
Status | Recruiting |
Enrollment | 120 |
Est. completion date | February 2021 |
Est. primary completion date | February 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 41 Years and older |
Eligibility |
Inclusion Criteria: - Age> 40 years - Patient with confirmed diagnosis of IPF according to the American Thoracic Society (ATS) / European Respiratory Society (ERS) / Japanese Respiratory Society (JRS) / Latin American Thoracic Association (ALAT) criteria. The patient may be included regardless of the date of diagnosis. - Advanced IPF with Forced Vital Capacity (FVC) <50%" of predicted value and / or Diffusing capacity for carbon monoxide ((DLCO) <30% of predicted value or inability to achieve the Functional Respiratory Investigations (EFR) due to respiratory severity. EFR dated less than 3 months. - Absence of argument for acute or subacute exacerbation in the last 6 months. - Patient who can be followed in ambulatory consultation/ outpatient consultation. - Informed consent signed (signed by the patient or in the presence of a third party for patients who are poorly fluent in French). - Affiliation to the social security system. Exclusion Criteria: - Patient unable to respond to quality of life questionnaires. - Inability (physical or mental) to give a written informed consent. - Acute exacerbation of fibrosis in the previous 6 months. - Patient eligible for a pulmonary transplant. - Participation in other therapeutic trial - Patient cannot be followed in ambulatory consultation. - Patient under trustee |
Country | Name | City | State |
---|---|---|---|
France | Centre Hospitalier Robert Ballanger | Aulnay-sous-Bois | |
France | Hôpital Avicenne | Bobigny | |
France | Centre Hospitalier de Versailles Andre Mignot | Le Chesnay | |
France | Hôpital LOUIS PRADEL | Lyon | |
France | Hôpital NORD | Marseille | |
France | Hôpital MARC JACQUET | Melun | |
France | Hôpital GEORGES POMPIDOU (HEGP) | Paris | |
France | Hôpital Tenon | Paris | |
France | Hôpital Pontchaillou | Rennes | |
France | Hôpital DELAFONTAINE | Saint-Denis | |
France | Hôpital LARREY | Toulouse |
Lead Sponsor | Collaborator |
---|---|
Assistance Publique - Hôpitaux de Paris |
France,
Swigris JJ, Brown KK, Behr J, du Bois RM, King TE, Raghu G, Wamboldt FS. The SF-36 and SGRQ: validity and first look at minimum important differences in IPF. Respir Med. 2010 Feb;104(2):296-304. doi: 10.1016/j.rmed.2009.09.006. Epub 2009 Oct 7. — View Citation
Swigris JJ, Kuschner WG, Jacobs SS, Wilson SR, Gould MK. Health-related quality of life in patients with idiopathic pulmonary fibrosis: a systematic review. Thorax. 2005 Jul;60(7):588-94. Review. — View Citation
Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010 Aug 19;363(8):733-42. doi: 10.1056/NEJMoa1000678. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The benefit of a systematic, formalized and joint intervention of a palliative intervention staff and a chest physician team on quality of life, evaluated after 6 months by the Short Form (36) Health Survey. | The Short Form (36) Health Survey is a 36-item, patient-reported survey of patient health. The Short Form (36) Health Survey consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. The eight sections are: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, mental health. This score has already been used for IPF | at 6 months after inclusion | |
Secondary | The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Mood and depression | evaluated by the Hospital Anxiety and Depression questionnaire. Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives Respiratory symptoms (dyspnea) The course of care, the use of palliative care stays and the duration of hospital stays (number and duration of hospitalizations). Overall survival and place of death. |
at 3 and 6 months after inclusion | |
Secondary | The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives. | the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives will be evaluated by the illness understanding questionnaire. | at 3 and 6 months after inclusion | |
Secondary | The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Respiratory symptoms (dyspnea) | The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Respiratory symptoms (dyspnea) will be evaluated by St George's respiratory questionnaire (SGRQ) and Transition Dyspnea Index (TDI) | at 3 and 6 months after inclusion | |
Secondary | The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the course of care. | the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the course of care, the use of palliative care stays and the duration of hospital stays (number and duration of hospitalizations) | at 3 and 6 months after inclusion | |
Secondary | The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the Overall survival. | the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the Overall survival measured between inclusion and date of death or last news. | between inclusion and date of death or last news. (survival follow-up visit at month 12) | |
Secondary | Carry out a medico-economic study evaluating the incremental cost-utility and cost-effectiveness ratio (overall survival criterion) | This outcome is evaluated by the medico-economic questionnaire : EuroQol five dimensions questionnaire (EQ-5D) | at 3 and 6 months after inclusion |
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