Palliative Care Intervention, "TARGET-PC"
OtherPalliative care intervention focused on eliciting patients' goals and values to facilitate discussion and documentation of health care preferences.
NCT Number: NCT06795529
Many people living with metastatic breast cancer face challenging symptoms and frequent medical visits. At the same time, conversations about personal goals, values, and preferences for care may not always happen as early or as often as patients and families would like. This multi-site study will test the effectiveness of a five-session palliative care program, designed specifically for people with metastatic breast cancer and their caregivers, to strengthen communication with clinicians about what matters most in their care. The study aims to inform how palliative care services can be delivered in a more timely, personalized, and scalable way for people living with advanced cancers who have long disease trajectories, such as metastatic breast cancer.
Interested in participating?
Request Info18 year and older
All sexes
Interventional
Not applicable
Massachusetts General Hospital, Boston, Massachusetts, United States
The diagnosis of metastatic breast cancer can bring many challenges including physical symptoms, treatment side effects, and emotional stress for patients and their families. Palliative care specialists work alongside the oncology team to help patients and families manage symptoms, communicate effectively with their clinicians, and cope with the impact of living with cancer.
Research has shown that when palliative care and oncology teams collaborate closely, patients often experience better symptom relief, clearer communication about their goals and preferences, improved quality of life and mood, and a stronger understanding of their illness. Caregivers also report feeling more supported and less distressed.
The purpose of this research study is to learn whether a personalized palliative care program for people with metastatic breast cancer and their caregivers, called TARGET-PC, can further improve communication, symptom management, coping skills, and understanding of care.
In this study, 400 patients with metastatic breast cancer and their caregivers will be randomly assigned to receive either the TARGET-PC program or enhanced usual care. Enhanced usual care includes an electronic prompt that reminds oncology clinicians to discuss and record each patient's goals and preferences for care. The study will take place at the Massachusetts General Hospital Cancer Center, Penn Abramson Cancer Center, and Duke Cancer Center.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Patient Inclusion Criteria:
Patient Exclusion Criteria:
Caregiver Inclusion Criteria:
Palliative care intervention focused on eliciting patients' goals and values to facilitate discussion and documentation of health care preferences.
Oncology clinicians will receive an electronic message to encourage them to discuss and document their patients' health care preferences.
Time frame: From date of randomization until date of death or last follow up assessed up to 60 months
To compare proportions of patients with clinician-documented end-of-life care preferences in the electronic health record by last follow-up time point or date of death between study groups.
Time frame: From date of randomization until date of death or last follow up assessed up to 60 months
To compare proportions of patients using hospice services by last follow up time point or death of death between study groups.
Time frame: From date of randomization until date of death or last follow up assessed up to 60 months
To compare patients' lengths of stay in hospice between study groups among patients who die during study follow up.
Time frame: From date of randomization until date of death or last follow up assessed up to 60 months
To compare proportions of patients dying in the hospital between study groups among patients who die during study follow up.
Time frame: From date of randomization until date of death or last follow up assessed up to 60 months
To compare proportions with patient-reported communication about their end-of-life care preferences between study groups by last follow-up time point or date of death using the Prognosis and Treatment Perceptions Questionnaire (PTPQ). The PTPQ has a single item in which patients indicate whether they have discussed their end-of-life care wishes with their clinicians (scored dichotomously as "yes or no").
Time frame: 24 Weeks
To compare patient-reported quality of life per the Functional Assessment of Cancer Therapy-Breast (FACT-B) Scale between study groups at 24 weeks. The FACT-B total scale scores range from 0-148, with higher scores indicating better quality of life.
Time frame: 24 weeks
To compare patient-reported anxiety and depression symptoms per the Hospital Anxiety and Depression Scale (HADS) between study groups at 24 weeks. HADS subscale scores range from 0-21, with higher scores indicating worse distress.
Time frame: 24 weeks
To compare patient-reported use of approach-oriented and avoidant coping strategies per the Brief-COPE between study groups at 24 weeks. The Brief-COPE approach-oriented subscale scores range from 6-24, and the avoidant subscale scores range from 4-16, with higher scores indicating greater use of each strategy.
Time frame: 24 Weeks
To compare caregiver-reported quality of life per the Caregiver Oncology Quality-of-Life Questionnaire (CarGOQoL) between study groups at 24 weeks. The CarGOQoL total scale scores range from 0-100, with higher scores indicating better quality of life.
Time frame: 24 weeks
To compare caregiver-reported anxiety and depression symptoms per the Hospital Anxiety and Depression Scale (HADS) between study groups at 24 weeks. HADS subscale scores range from 0-21, with higher scores indicating worse distress.
Time frame: 24 weeks
To compare caregiver-reported use of approach-oriented and avoidant coping strategies per the Brief-COPE between study groups at 24 weeks. The Brief-COPE approach-oriented subscale scores range from 6-24, and the avoidant subscale scores range from 4-16, with higher scores indicating greater use of each strategy.
Time frame: From date of randomization until date of death or last follow up assessed up to 60 months
To compare caregiver-reported communication about the patient's end-of-life care preferences between study groups by last follow-up time point or the patient's date of death using the Prognosis and Treatment Perceptions Questionnaire (PTPQ). The PTPQ has a single item in which caregivers indicate whether they have discussed the patient's end-of-life care wishes with their clinicians (scored dichotomously as "yes or no").
Time frame: From date of randomization until three months after the patient's death assessed up to 60 months
To compare caregiver-reported assessment of the patient's end-of-life experiences between study groups among caregivers of patients who die during the study period as measured by three items ranging from 0-10, with higher scores indicating worse quality of end-of-life.
Contact information is provided by the study sponsor or research team.
Jennifer Temel, MD
CONTACT
Joseph Greer, PhD
CONTACT
Massachusetts General Hospital
Other
Randomized Trial of a Targeted Palliative Care Intervention for Patients With Metastatic Breast Cancer
Acronym: TARGET-PC
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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