Metastases to Bone Clinical Trial
Official title:
A Pilot Project to Assess the Feasibility of Integrating a Multidisciplinary Rapid Access Metastatic Bone Disease Program (RAMP) at The Ottawa Hospital
The skeletal system is one of the most common sites for metastatic spread of many malignancies. Metastatic bone disease (MBD) can be associated with a significant reduction in quality of life due to debilitating pain and pathologic fractures. Multiple providers are involved in treating patients with MBD which can result in fragmented and delayed delivery of care. This fragmentation also leads to poor outcomes and patient experience. This project will assess whether it is feasible to integrate a multidisciplinary Rapid Access Metastatic Bone Disease Program (RAMP) at the Investigator's institution to improve the delivery of care to patients presenting with pelvic and lower extremity MBD. The goals of RAMP are: 1) Improve outcome and quality of care provided to MBD patients. 2) Improve patients experience through the participant's treatment journey. 3) Avert extra health care costs caused by unplanned admissions through ER and decrease redundancies due to unnecessary multiple clinic visits and double-ordering of diagnostic tests. This project will be designed to optimize the use of existing clinic resources more efficiently. Cancer patients and their loved ones will be actively engaged in the design of this project to better achieve its goals.
More than 140,000 new cases of cancer are diagnosed annually in Canada, with nearly half of
which metastasize to bone. The skeletal system is one of the most common sites for metastatic
spread of many visceral malignancies, especially cancers originating from breast, prostate,
lung, thyroid and kidney. Hematologic malignancies, such as multiple myeloma and lymphoma,
also primarily manifest with multiple aggressive lytic lesions in the bone. A Skeletal
Related Event (SRE) is the term given when a metastatic lesion arises in bone. With advances
in effective systemic treatment and supportive care, the duration of survival of patients
with bone metastases has improved substantially. This improvement in survival can be
accompanied by significant morbidity and reduction in quality of life secondary to pain,
pathologic fracture, and spinal cord compression from SREs. Pain and impaired mobility occur
in approximately 65%-75% of patients with bone metastases. SREs are also associated with high
economic burden secondary to increased costs of treatment and high rates of hospitalizations.
It is estimated that a single episode of SRE can cost the medical system 36,462 USD. The
current literature reflects significant diversity in the approach of diagnosing and treating
MBD. Therefore, numerous studies have advocated the need for a multidisciplinary clinic to
co-ordinate the diagnosis, treatment, and rehabilitation of patients with MBD patients. This
strategy has also been proposed to improve the delivery of early and multimodal palliative
management for patients in a cost effective approach.
Aims and Objectives: The aims of this project are: 1) Assess feasibility of establishing and
integrating a multidisciplinary Rapid Access Metastatic Bone Disease Program (RAMP) at the
Investigator's institution to improve the delivery of care to patients presenting with pelvic
and lower extremity MBD. 2) Centralize referrals and streamline clinical care pathways for
patients diagnosed with MBD to pelvis and lower extremity. 3) Assess improvement in outcome
and patient experience. The objectives of this project are: 1) Establish a core
multidisciplinary RAMP team to develop a patient-centered clinical care pathway for diagnosis
and treatment. 2) Establish a standardized and rapid referral process for RAMP. 3) Triage
consults and coordinate their integration into pre-existing weekly "musculoskeletal oncology"
clinic at the cancer center. 4) Develop a centralized registry for patients presenting to
RAMP to assess provider performance and evaluate the success of established clinical care
pathways.
;
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT04170634 -
Tumoral Bone Strength Assessment by Numerical Simulation Using Quantitative CT : the MEKANOS Study
|
||
| Completed |
NCT06244498 -
Tranexamic Acid After Pathological Fracture Treated With Modular Arthroplasty
|