Enhanced Outpatient Symptom Management to Reduce Acute Care Visits Due to Chemotherapy-Related Adverse Events

NCT05038254 — Not applicable, Active not recruiting, 750 participants, M.D. Anderson Cancer Center

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There Is No Place Like Home- A Pragmatic Effectiveness Trial of Technology-Enhanced Outpatient Symptom Management to Reduce Acute Care Visits Due to Chemotherapy-Related Adverse Events

RegistryNCT05038254
StatusActive not recruiting
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, health services research
Enrollment750 (Estimated)
SponsorM.D. Anderson Cancer Center (Other)
ConditionsClinical Stage IV Esophageal Adenocarcinoma AJCC v8, Clinical Stage IV Esophageal Squamous Cell Carcinoma AJCC v8, Clinical Stage IV Gastric Cancer AJCC v8, Clinical Stage IVA Esophageal Adenocarcinoma AJCC v8, Clinical Stage IVA Esophageal Squamous Cell Carcinoma AJCC v8, Clinical Stage IVA Gastric Cancer AJCC v8, Clinical Stage IVB Esophageal Adenocarcinoma AJCC v8, Clinical Stage IVB Esophageal Squamous Cell Carcinoma AJCC v8, Clinical Stage IVB Gastric Cancer AJCC v8, Metastatic Colon Carcinoma, Metastatic Esophageal Carcinoma, Metastatic Gastric Carcinoma, Metastatic Liver Carcinoma, Metastatic Malignant Digestive System Neoplasm, Metastatic Malignant Small Intestinal Neoplasm, Metastatic Malignant Thoracic Neoplasm, Metastatic Pancreatic Carcinoma, Metastatic Rectal Carcinoma, Pathologic Stage IV Esophageal Adenocarcinoma AJCC v8, Pathologic Stage IV Esophageal Squamous Cell Carcinoma AJCC v8, Pathologic Stage IV Gastric Cancer AJCC v8, Pathologic Stage IVA Esophageal Adenocarcinoma AJCC v8, Pathologic Stage IVA Esophageal Squamous Cell Carcinoma AJCC v8, Pathologic Stage IVB Esophageal Adenocarcinoma AJCC v8, Pathologic Stage IVB Esophageal Squamous Cell Carcinoma AJCC v8, Postneoadjuvant Therapy Stage IV Esophageal Adenocarcinoma AJCC v8, Postneoadjuvant Therapy Stage IV Esophageal Squamous Cell Carcinoma AJCC v8, Postneoadjuvant Therapy Stage IV Gastric Cancer AJCC v8, Postneoadjuvant Therapy Stage IVA Esophageal Adenocarcinoma AJCC v8, Postneoadjuvant Therapy Stage IVA Esophageal Squamous Cell Carcinoma AJCC v8, Postneoadjuvant Therapy Stage IVB Esophageal Adenocarcinoma AJCC v8, Postneoadjuvant Therapy Stage IVB Esophageal Squamous Cell Carcinoma AJCC v8, Stage IV Colon Cancer AJCC v8, Stage IV Hepatocellular Carcinoma AJCC v8, Stage IV Pancreatic Cancer AJCC v8, Stage IV Rectal Cancer AJCC v8, Stage IV Small Intestinal, Esophageal, Colorectal, Mesenteric, and Peritoneal Gastrointestinal Stromal Tumor AJCC v8, Stage IVA Colon Cancer AJCC v8, Stage IVA Hepatocellular Carcinoma AJCC v8, Stage IVA Rectal Cancer AJCC v8, Stage IVB Colon Cancer AJCC v8, Stage IVB Hepatocellular Carcinoma AJCC v8, Stage IVB Rectal Cancer AJCC v8, Stage IVC Colon Cancer AJCC v8, Stage IVC Rectal Cancer AJCC v8
InterventionsBest Practice, Patient Monitoring, Questionnaire Administration (Other, procedure)
Datesstart 2021-05-12, primary completion 2028-01-31 (estimated), completion 2028-01-31 (estimated), first posted 2021-09-09, last updated 2026-06-16
Locations1 site in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Clinical Stage IV Esophageal Adenocarcinoma AJCC v8 All trials for Clinical Stage IV Esophageal Squamous Cell Carcinoma AJCC v8 All trials of Best Practice All trials of Patient Monitoring

-Summary

This clinical trial studies if enhanced outpatient symptom management with telemedicine and remote monitoring can help reduce acute care visit due to chemotherapy-related adverse events. Receiving telemedicine and remote monitoring may help patients have better outcomes (such as fewer avoidable emergency room visits and hospitalizations, better quality of life, fewer symptoms, and fewer treatment delays) than patients who receive usual care.

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+Detailed description

PRIMARY OBJECTIVE:

I. Determine the efficacy of remote patient monitoring (RPM) on improving clinical outcomes.

SECONDARY OBJECTIVE:

I. Evaluate the following patient-centered outcomes: treatment delays, health-related quality-of-life (HRQOL), patient activation, and family caregiver-experience.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive standard of care consisting of oncology care provided via telemedicine.

ARM II: Patients receive standard of care consisting of oncology care provided via telemedicine. Patients also undergo remote monitoring.

+Arms and interventions

ArmTypeInterventionsDescription
Arm I (standard of care)Active comparatorOther: Best Practice; Other: Questionnaire AdministrationPatients receive standard of care consisting of oncology care provided via telemedicine.
Arm II (standard of care, remote monitoring)ExperimentalOther: Best Practice; Procedure: Patient Monitoring; Other: Questionnaire AdministrationPatients receive standard of care consisting of oncology care provided via telemedicine. Patients also undergo remote monitoring.
Arm III (standard of care, remote monitoring, biometrics)ExperimentalOther: Best Practice; Procedure: Patient Monitoring; Other: Questionnaire AdministrationPatient receive standard of care consisting of oncology care provided via telemedicine. Patients also undergo remote monitoring and biometric monitoring.
  • Best Practice (Other), also known as standard of care, standard therapy: Receive standard of care telemedicine
  • Patient Monitoring (Procedure), also known as medical monitoring, monitor: Undergo remote monitoring
  • Questionnaire Administration (Other): Ancillary studies

+Outcome measures

Primary outcomes

  • Rate of acute care visits [Up to 3 months]: Defined as the proportion of unique oncology patients with emergency room visits or hospital admission over a 3-month period.

Secondary outcomes

  • Change in health-related quality of life (HRQOL) [Baseline to 6 months]: HRQOL will be assessed using the Patient Reported Outcomes Measurement Information System (PROMIS) Profile-29 version 2.1.
  • Change in patient engagement [Baseline to 6 months]: Patient engagement will be evaluated with the 13-item Patient Activation Measure (PAM), which assesses knowledge, skill, and self-efficacy for self-management of health
  • Change in symptom management [Baseline to 6 months]: Daily symptoms will be measured using the Common Terminology Criteria for Adverse Events version 5.

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Adults (≥ 18 years)
* English- and Spanish-fluent participants with thoracic and/or gastrointestinal cancers who are scheduled to initiate or continue outpatient chemotherapy at either MDACC (Texas Medical Center campus and any Houston-area location) or MDACC oncology clinic at Lyndon B Johnson (LBJ) hospital
* Their adult (≥18 years) patient-identified or self-identified primary caregivers (MDACC only)
* Participants on combination chemotherapy and immunotherapy or combination chemotherapy and biologic will also be eligible for inclusion.
* Participants may participate if they do not have a caregiver, or if their caregiver declines participation; however, caregivers of MDACC participants may participate only if the participant consents.

Exclusion Criteria:

* Participants who are receiving investigational new drug treatments or concurrently enrolled in a phase 1 clinical trial will be excluded due to the associated structured reporting and regulatory requirements.
* Participants with a requirement for inpatient infusion (i.e. CAR-T cell therapy), living in institutional settings (i.e. prison, nursing homes), with a history of dementia, physical disability or neurological deficits that prohibit ability to report symptom burden will also be excluded.

+Locations (1)

FacilityCityCountryStatus
M D Anderson Cancer CenterHouston, TexasUnited States

+Publications

  • Results publication: Offodile AC 2nd, Delgado D, Lin YL, Geyen D, Miller CJ, Jain S, Finder JP, Shete S, Fossella FV, Overman MJ, Peterson SK. Integration of Remote Symptom and Biometric Monitoring Into the Care of Adult Patients With Cancer Receiving Chemotherapy-A Decentralized Feasibility Pilot Study. JCO Oncol Pract. 2023 Jun;19(6):e811-e821. doi: 10.1200/OP.22.00676. Epub 2023 Feb 23. PMID 36821818

+Investigators