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Completed

NCT Number: NCT01885884

Supportive Care Intervention-Pancreas

This is a pilot, randomized controlled trial of an embedded collaborative model of supportive care designed to improve quality of life and decrease use of unwanted healthcare services at the end of life for patients with advanced pancreatic cancer. We will enroll 30 patients who are receiving treatment at the Hillman Cancer Center for recently diagnosed, locally advanced or metastatic pancreatic adenocarcinoma, as well as their accompanying caregivers and providers. Patients will be randomized to receive either the supportive care intervention or usual care. The purpose of this study is to refine an embedded collaborative model of supportive care and to develop protocols for recruitment, randomization, and longitudinal data collection.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Pittsburgh Cancer Institute (UPCI), Hillman Cancer Center

Pittsburgh, Pennsylvania, 15232, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients:
  • Adults (≥ 18 years old)
  • Pathologically-confirmed locally advanced or metastatic pancreatic adenocarcinoma diagnosed within the past 8 weeks
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 (asymptomatic), 1 (symptomatic but fully ambulatory), or 2 (symptomatic and in bed <50% of the day)
  • Planning to receive continued care from an oncologist at the Hillman Cancer Center
  • Accompanied by a caregiver (family member or friend) at the first visit
  • Caregivers:
  • Adults (>= 18 years old)
  • Family member or friend of an eligible patient

Exclusion criteria

  • Patients:
  • Unable to read and respond to questions in English
  • Not planning to receive continued care from an oncologist at the Hillman Cancer Center
  • Pancreatic neuroendocrine cancer
  • Caregivers:
  • Unable to read and respond to questions in English

Treatment and study plan

Embedded Supportive Care

Behavioral

Primary outcomes

  1. trial feasibility

    Time frame: up to 2 years

    We will assess trial feasibility by monitoring number of eligible patients per clinic day, contact rates, interest rates, enrollment rates, randomization rates, intervention visit completion rates, and outcome assessment completion rates.

  2. acceptability of intervention participation

    Time frame: 3 months (+/- 3 weeks) from patient enrollment

    We will report the percentage of patients and caregivers who found the intervention acceptable.

  3. intervention fidelity

    Time frame: Up to 2 years

    We will use post-visit checklists to characterize the number and types of recommended topics covered during each supportive care intervention visit.

  4. perceived effectiveness

    Time frame: 3 months (+/- 3 weeks) from patient enrollment

    We will report the percentage of patients and caregivers who perceived the intervention to be effective for treating symptoms, understanding their illness, coping, and planning for the future.

Secondary outcomes

  1. change in patient quality of life

    Time frame: baseline (enrollment) to 3 months (+/- 3 weeks) after enrollment

    We will summarize range and distribution of change in patient quality of life from baseline to 3 months using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep). Because this is a pilot trial, we will not conduct formal tests of efficacy.

  2. patient healthcare utilization

    Time frame: up to 2 years

    We will summarize range and distribution of the following patient healthcare utilization outcomes: number and types of chemotherapy regimens, frequency and timing of chemotherapy regimens, number and length (days) of hospital admissions, number and length (days) of ICU admissions, number of emergency department visits, frequency and timing (days before death) of hospice use, place of death. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  3. patient quality of life

    Time frame: 3 months (+/- 3 weeks) from patient enrollment

    We will summarize range and distribution of patient quality of life at 3 months using the FACT-Hep scale. Because this is a pilot trial, we will not conduct formal tests of efficacy.

Other outcomes

  1. patient illness understanding and care preferences

    Time frame: 3 months (+/- 3 weeks) from patient enrollment

    We will assess range and distribution of patient illness understanding using validated questions about patients' perceptions of curability, life expectancy, acknowledgement of whether or not s/he has a terminal illness, and preferences for comfort-oriented vs life-prolonging treatment. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  2. change in patient anxiety symptoms

    Time frame: baseline (enrollment) to 3 months (+/- 3 weeks) after enrollment

    We will assess change in patient anxiety symptoms with the Hospital Anxiety and Depression Scale (HADS) administered at baseline and 3 months. HADS scores will be compiled to assess range and distribution. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  3. change in patient distress

    Time frame: baseline (time of enrollment) to 3 months (+/- 3 weeks) after enrollment

    We will summarize range and distribution of change in patient distress responses from baseline to 3 months, collected with the National Comprehensive Cancer Network (NCCN) Distress Thermometer tool, where patients rate their distress on a visual guide from 0, 'no distress' to 10, 'extreme distress.' Scores will be compiled to assess range and distribution at 3-months. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  4. change in patient depressive symptoms

    Time frame: baseline (enrollment) to 3 months (+/- 3 weeks) after enrollment

    We will assess change in patient depression from baseline to 3 months with the Hospital Anxiety and Depression Scale (HADS) and the Primary Care Evaluation of Mental Disorders: Patient Health Questionnaire (PRIME-MD PHQ-9). HADS and PHQ-9 depression scores will be compiled to assess range and distribution at baseline and 3 months. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  5. change in caregiver distress

    Time frame: baseline (enrollment) to 3 months (+/- 3 weeks) after enrollment

    We will summarize range and distribution of change in caregiver distress responses from baseline to 3 months, collected with the National Comprehensive Cancer Network (NCCN) Distress Thermometer tool. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  6. change in caregiver burden

    Time frame: baseline (enrollment) to 3 months (+/- 3 weeks) after enrollment

    We will summarize the range and distribution of the reported change in caregiving burden from baseline to 3 months, collected with the Zarit Burden Interview and Family Member Concerns scale. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  7. caregiver grief

    Time frame: 1-3 months after death of enrolled patient

    We will assess caregiver grief after the death of their loved one (enrolled patient), if the patient dies during study participation and up to 2-year follow up. We will use the Inventory of Complicated Grief to assess how much and how often caregivers are affected by the loss of their loved one and summarize the range and distribution of this data. Because this is a pilot study, we will not conduct formal tests of efficacy.

  8. change in caregiver anxiety symptoms

    Time frame: baseline (enrollment) to 3 months (+/- 3 weeks) after enrollment

    We will assess change in caregiver anxiety symptoms from baseline to 3 months with the Hospital Anxiety and Depression Scale (HADS). HADS scores will be compiled to assess range and distribution. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  9. change in caregiver depressive symptoms

    Time frame: baseline (enrollment) to 3 months (+/- 3 weeks) after enrollment

    We will assess change in caregiver depressive symptoms from baseline to 3 months with the Hospital Anxiety and Depression Scale (HADS). HADS scores will be compiled to assess range and distribution. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  10. caregiver perceptions of circumstances surrounding death and preparedness for death

    Time frame: 1-3 months after death of enrolled patient

    We will assess caregiver perceptions of circumstances surrounding death and preparedness for death using four previously validated questions. We will summarize range and distribution of responses. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  11. quality of life of seriously ill patients

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will summarize range and distribution of patient quality of life using the Quality of Life - Seriously Ill Patients (QUAL-E) score. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  12. patient emotional acceptance of illness

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will summarize range and distribution of patient emotional acceptance of illness using the PEACE Scale. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  13. patient anxiety

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will summarize range and distribution of patient anxiety using the Hospital Anxiety and Depression Scale (HADS). Because this is a pilot trial, we will not conduct formal tests of efficacy.

  14. patient distress

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will summarize range and distribution in patient distress responses, collected with the National Comprehensive Cancer Network (NCCN) Distress Thermometer tool, where patients rate their distress on a visual guide from 0, 'no distress' to 10, 'extreme distress.' Because this is a pilot trial, we will not conduct formal tests of efficacy.

  15. patient depression

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will assess patient depression from with the Hospital Anxiety and Depression Scale (HADS) and the Primary Care Evaluation of Mental Disorders: Patient Health Questionnaire (PRIME-MD PHQ-9). HADS and PHQ-9 depression scores will be compiled to assess range and distribution. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  16. caregiver distress

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will summarize range and distribution in caregiver distress responses, collected with the National Comprehensive Cancer Network (NCCN) Distress Thermometer tool. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  17. caregiver burden

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will summarize the range and distribution of the reported caregiving burden, collected with the Zarit Burden Interview and Family Member Concerns scale. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  18. caregiver anxiety symptoms

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will assess caregiver anxiety symptoms with the Hospital Anxiety and Depression Scale (HADS). HADS scores will be compiled to assess range and distribution. Because this is a pilot trial, we will not conduct formal tests of efficacy.

  19. caregiver depressive symptoms

    Time frame: 3 months (+/- 3 weeks) after enrollment

    We will assess caregiver depressive symptoms with the Hospital Anxiety and Depression Scale (HADS). HADS scores will be compiled to assess range and distribution. Because this is a pilot trial, we will not conduct formal tests of efficacy.

Sponsors and collaborators

Lead sponsor

University of Pittsburgh

Other

Registry information

Official study title

A Pilot Trial of an Embedded Collaborative Model of Supportive Care for Pancreatic Cancer

Acronym: SCI-P

Important dates

Study start
2013
Primary completion
2015
Study completion
2015
First posted
Jun 25, 2013
Registry last updated
May 12, 2016

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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