PRESENCE Project: An Early Palliative Care Intervention in Brain Tumors

NCT ID: NCT01652768

Last Updated: 2013-08-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

1 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-12-31

Study Completion Date

2013-08-31

Brief Summary

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The purpose of this pilot study is to investigate the feasibility of an early palliative care intervention (PRESENCE: Providing Resources Education, Support, and Enabling New brain tumor patients to Cope Effectively) and the effect of the intervention on patient and caregiver distress.

Detailed Description

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Patients and caregivers will be enrolled in two phases. Phase I is a qualitative study exploring the experience of primary caregivers of patients with a new diagnosis of malignant brain tumor during the first 10 weeks of the diagnosis and beginning treatment process. During Phase I, only caregivers patients with a malignant brain tumor who are at least two months and not more than six months into treatment at the Seidman Cancer Center (SCC)will be enrolled. They will be asked to participate in a qualitative interview to describe the newly diagnosed experience (diagnosis through first 10 weeks of treatment) of having a loved one with a malignant brain tumor.

A convenience sample of 20 patients and their primary caregivers will be enrolled for Phase II of this pilot project. The first ten patients and caregivers enrolled will receive usual care (Phase II, Arm A). Usual care is defined as standard post-operative care on a surgical unit in University Hospitals Case Medical Center. Discharge planning will be provided by the assigned in-patient social worker. Referrals to the assigned outpatient social worker will be made as appropriate. Patients and caregivers will be seen in the ambulatory medical oncology setting about three to six weeks after surgery, depending on post-operative recovery time.

The second ten patients and caregivers enrolled will receiving the intervention (Phase II, Arm B). The unique features of the PRESENCE Project (PP) Intervention are 1) the early palliative care intervention (immediately post-op) provided by the new palliative care brain tumor team (Social worker, advanced practice nurse (APN), medical oncology registered nurse); 2) an educational information session for patients and caregivers; and 3) frequent (every two week and as needed) telephone or clinic visits during the first ten weeks post operatively. In usual care, the patient and caregiver receive little supportive care until they begin cancer treatment. The intervention provides aggressive supportive care from the time of diagnosis.

RESEARCH OBJECTIVES:

1. To investigate the feasibility of an early palliative care intervention (PRESENCE: Providing Resources Education, Support, and Enabling New brain tumor patients to Cope Effectively) for patients newly diagnosed with a malignant brain tumor and their primary caregivers.
2. To explore the experience of being a caregiver of a patient newly diagnosed with a malignant brain tumor.
3. To determine the effect of the PRESENCE Intervention on patient and caregiver distress, anxiety, and depression.
4. To determine the effect of the PRESENCE Intervention on caregiver reaction (benefit and burden) and caregiver mastery.

Conditions

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Malignant Brain Tumors

Keywords

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Malignant Brain Tumors Malignant Glioma High-grade Gliomas Oncology Cancer Patient Caregiver Caregiver Stress, Anxiety, Depression Palliative Care Intervention

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Arm A: Usual Care Group

Usual care is defined as standard post-operative care on a surgical unit in University Hospitals Case Medical Center. Discharge planning will be provided by the assigned in-patient social worker. Referrals to the assigned outpatient social worker will be made as appropriate. Patients and caregivers will be seen in the ambulatory medical oncology setting about three to six weeks after surgery, depending on post-operative recovery time. The research assistant will administer the research questionnaires at week one post-surgery and 8-10 weeks post surgery.

Group Type ACTIVE_COMPARATOR

Research Questionnaires

Intervention Type OTHER

Hospital Anxiety and Depression Scale Pearlin \& Schooler Caregiver Mastery Caregiver Assessment Tool Patient/Caregiver Satisfaction Survey

Arm B: PRESENCE Intervention

The unique features of the PRESENCE Project (PP) Intervention are 1) the early palliative care intervention (immediately post-op) provided by the new palliative care brain tumor team (Social worker, advanced practice nurse (APN), medical oncology registered nurse); 2) an educational information session for patients and caregivers; and 3) frequent (every two week and as needed) telephone or clinic visits during the first ten weeks post operatively (Figure 1). In usual care, the patient and caregiver receive little supportive care until they begin cancer treatment. The intervention provides aggressive supportive care from the time of diagnosis.

Group Type EXPERIMENTAL

Educational Information Session for Patients and Caregivers

Intervention Type OTHER

Provide an educational class "Moving Forward: Facing a Brain Tumor Diagnosis" for patient and caregiver Week 5 through 7: The PRESENCE Project Social Worker and oncology RN will provide an educational class.

Intervention (Length of time for class = 2 hours):

1. Provide an educational class "Moving Forward: Facing a Brain Tumor Diagnosis" for patient and caregiver.
2. Provide additional resources/referrals for any needs that are identified by patient or care partner during the educational class.
3. Provide supportive care.

Research Questionnaires

Intervention Type OTHER

Hospital Anxiety and Depression Scale Pearlin \& Schooler Caregiver Mastery Caregiver Assessment Tool Patient/Caregiver Satisfaction Survey

Palliative Care Team

Intervention Type OTHER

Week 1: Early palliative care intervention (immediately post-op) provided by the new palliative care brain tumor team (Social worker, advanced practice nurse (APN), medical oncology registered nurse).

1. Introduce the palliative care team concept.
2. Provide contact information for the palliative care team given
3. Administer Initial Patient and Caregiver Psychosocial Assessments (Appendix A)
4. Offer community resources to patient and caregiver (Appendix B)
5. Provide additional resources/referrals for any needs that are identified by patient or care partner during initial psychosocial assessment
6. Provide supportive care

Contact every 2 weeks

Intervention Type OTHER

The PRESENCE Project APN and/or Presence Project Social Worker will contact the patient and caregiver via telephone or office visit every two weeks and as needed until the second medical oncology visit.

(Anticipated length of time for phone intervention or visit is 20 minutes; however, length of time for intervention is tailored to the patient and caregiver's needs):

1. Administer Patient and Caregiver Follow-up Assessment
2. Provide pain and/or symptom management intervention for any issues identified during the follow-up assessment
3. Provide resources/referrals for any needs identified during the social work follow-up assessment
4. Provide supportive care

Follow-up Surgical Visit Session

Intervention Type OTHER

The PRESENCE Project APN will meet with patient and caregiver at the surgical follow-up visit, approximately two weeks after surgery.

Intervention (Anticipated length of time for visit is about 30 minutes; however length of time for intervention is tailored to the patient and caregiver's needs):

1. Administer Patient and Caregiver Follow-up Assessment
2. Administer Symptom Assessment Tool
3. Provide pain and/or symptom management intervention
4. Provide supportive care

Medical and/or Radiation Oncology Appointment Session

Intervention Type OTHER

The PRESENCE Project APN and/or Presence Project Social Worker will meet with patient and caregiver at the first medical and/or radiation oncology appointment (weeks 3 and 4).

Intervention (Anticipated length of time for visit is about 30 minutes; however length of time for intervention is tailored to the patient and caregiver's needs):

1. Administer Patient and Caregiver Follow-up Assessment
2. Re-assess pain and/or symptom management issues and /or intervention
3. Provide resources/referrals for any needs identified during the social work follow-up assessment
4. Provide supportive care.

Interventions

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Educational Information Session for Patients and Caregivers

Provide an educational class "Moving Forward: Facing a Brain Tumor Diagnosis" for patient and caregiver Week 5 through 7: The PRESENCE Project Social Worker and oncology RN will provide an educational class.

Intervention (Length of time for class = 2 hours):

1. Provide an educational class "Moving Forward: Facing a Brain Tumor Diagnosis" for patient and caregiver.
2. Provide additional resources/referrals for any needs that are identified by patient or care partner during the educational class.
3. Provide supportive care.

Intervention Type OTHER

Research Questionnaires

Hospital Anxiety and Depression Scale Pearlin \& Schooler Caregiver Mastery Caregiver Assessment Tool Patient/Caregiver Satisfaction Survey

Intervention Type OTHER

Palliative Care Team

Week 1: Early palliative care intervention (immediately post-op) provided by the new palliative care brain tumor team (Social worker, advanced practice nurse (APN), medical oncology registered nurse).

1. Introduce the palliative care team concept.
2. Provide contact information for the palliative care team given
3. Administer Initial Patient and Caregiver Psychosocial Assessments (Appendix A)
4. Offer community resources to patient and caregiver (Appendix B)
5. Provide additional resources/referrals for any needs that are identified by patient or care partner during initial psychosocial assessment
6. Provide supportive care

Intervention Type OTHER

Contact every 2 weeks

The PRESENCE Project APN and/or Presence Project Social Worker will contact the patient and caregiver via telephone or office visit every two weeks and as needed until the second medical oncology visit.

(Anticipated length of time for phone intervention or visit is 20 minutes; however, length of time for intervention is tailored to the patient and caregiver's needs):

1. Administer Patient and Caregiver Follow-up Assessment
2. Provide pain and/or symptom management intervention for any issues identified during the follow-up assessment
3. Provide resources/referrals for any needs identified during the social work follow-up assessment
4. Provide supportive care

Intervention Type OTHER

Follow-up Surgical Visit Session

The PRESENCE Project APN will meet with patient and caregiver at the surgical follow-up visit, approximately two weeks after surgery.

Intervention (Anticipated length of time for visit is about 30 minutes; however length of time for intervention is tailored to the patient and caregiver's needs):

1. Administer Patient and Caregiver Follow-up Assessment
2. Administer Symptom Assessment Tool
3. Provide pain and/or symptom management intervention
4. Provide supportive care

Intervention Type OTHER

Medical and/or Radiation Oncology Appointment Session

The PRESENCE Project APN and/or Presence Project Social Worker will meet with patient and caregiver at the first medical and/or radiation oncology appointment (weeks 3 and 4).

Intervention (Anticipated length of time for visit is about 30 minutes; however length of time for intervention is tailored to the patient and caregiver's needs):

1. Administer Patient and Caregiver Follow-up Assessment
2. Re-assess pain and/or symptom management issues and /or intervention
3. Provide resources/referrals for any needs identified during the social work follow-up assessment
4. Provide supportive care.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* are identified by the patient and/or caregiver as the "primary caregiver"
* were involved in caregiving during the first ten weeks following diagnosis at the SCC
* are capable of providing informed consent.


* are newly diagnosed malignant brain tumor patients who are at University Hospitals and who are within a week of surgery
* are receiving on-going care at the Seidman Cancer Center
* are able to identify a primary caregiver involved in their care, support, and/or care planning
* are capable of providing informed consent.

Exclusion Criteria

\- include those whose are caring for patients who are in hospice or within 2 months of death, as this experience may influence their recollection of the diagnosis phase of the cancer trajectory.


\- are those with a life expectancy of less than two months and/or those who are electing hospice care who will be receiving medical and or radiation oncology care outside of the Seidman Cancer Center.

Eligibility criteria for caregivers (Phase II)

* being identified by the patient as the "primary caregiver"
* capable of providing informed consent.
* Both the patient and caregiver must consent to be in the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Case Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Polly Mazanec, PhD

Role: PRINCIPAL_INVESTIGATOR

Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center

Locations

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Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center

Cleveland, Ohio, United States

Site Status

Countries

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United States

Other Identifiers

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CASE1310

Identifier Type: -

Identifier Source: org_study_id