Direct Improvement of Quality of Life Using a Tailored Pathway With Quality of Life Diagnosis and Therapy: Randomised Trial in Colorectal Cancer Patients

NCT ID: NCT02321813

Last Updated: 2017-09-25

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

COMPLETED

Clinical Phase

NA

Total Enrollment

220 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-31

Study Completion Date

2017-06-30

Brief Summary

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The purpose of the study is to determine whether a quality of life pathway with defined diagnostic and therapeutic options improves quality of life in colorectal cancer patients during follow-up.

Detailed Description

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There is a growing interest in using quality of life (QoL) data not only as relevant endpoint in clinical trials on cancer patients, but also in routine practice in order to improve patients' health during treatment. The investigators designed, implemented and evaluated an integrated quality of life diagnosis and therapy pathway (QoL pathway) for breast cancer patients (Klinkhammer-Schalke et al, 2008; 2012), guided by the UK Medical Research Council framework for developing and testing complex interventions. It could be demonstrated in a routine setting that breast cancer patients showed a benefit from tailored QoL diagnosis and therapy (Klinkhammer-Schalke et al, 2012).

But there is also requirement for managing QoL deficits of patients with other cancers and to replicate findings of the previous trial. To achieve this aim, the QoL pathway has been modified for colorectal cancer patients. The Tumor Center Regensburg provides the infrastructure of the present project (quality circles, project groups).

This is a two-arm randomised clinical trial with one intervention group and one control group. Patients' QoL is assessed with the EORTC QLQ-C30 and QLQ-CR29 at 0, 3, 6, 12, and 18 months after surgery.

In intervention group results of the QoL-measure are transferred to a QoL-profile including 13 dimensions on scales of 0-100 (cutoff for "diseased QoL \<50). Three experts with varying professional background use the individual patient's QoL-profile and clinical and sociodemographic information in order to generate a QoL-report including therapy recommendation which is sent to the coordinating practitioner. Specific therapeutic options for the treatment of diseased QoL have been identified: pain therapy, psychotherapy, social support, nutrition counseling, stoma care, physiotherapy, fitness. To provide continuous medical education, quality circles for each therapy option have been founded. Coordinating practitioners receive a list with addresses of all quality circle members.

In control group QoL is also measured but the coordinating practitioner neither receives a QoL-profile nor a QoL-report.

The investigators expect that patients in the intervention group will experience a lower number of QoL-deficits (QoL \< 50 points) in the first year after surgery compared with patients in the control group

Conditions

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Quality of Life Colorectal Neoplasms

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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intervention group

In the quality of life pathway results of the quality of life (QoL) measure are transferred to a QoL-profile. Three experts with various professional background use the individual patient's QoL-profile and clinical and sociodemographic information in order to generate a QoL-report including therapy recommendation which is sent to the coordinating practitioner. Specific therapeutic options for the treatment of diseased QoL have been identified: pain therapy, psychotherapy, social support, nutrition counseling, stoma care, physiotherapy, fitness. To provide continuous medical education, quality circles for each therapy option haven been founded. Coordinating practitioners receive a list with addresses of all quality circle members.

Group Type EXPERIMENTAL

quality of life pathway

Intervention Type BEHAVIORAL

Quality of life measurement, diagnosis and tailored therapy (pain therapy, psychotherapy, social support, nutrition, stoma care, physiotherapy, fitness)

control group

In control group QoL is also measured but the coordinating practitioner neither receives a QoL-profile nor a QoL-report.

Group Type PLACEBO_COMPARATOR

placebo control

Intervention Type OTHER

Quality of life measurement

Interventions

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quality of life pathway

Quality of life measurement, diagnosis and tailored therapy (pain therapy, psychotherapy, social support, nutrition, stoma care, physiotherapy, fitness)

Intervention Type BEHAVIORAL

placebo control

Quality of life measurement

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* primary colorectal cancer
* operated in one of four participating certified cancer centres for colorectal cancer (Krankenhaus Barmherzige Brüder, Department of Surgery, Regensburg; Germany; Caritas-Krankenhaus St. Josef, Department of Surgery, Regensburg; Germany; Klinikum Neumarkt., Department of Surgery, Neumarkt; Germany; Klinikum St. Elisabeth Straubing, Department of Surgery, Straubing, Germany), documented in a population-based cancer registry (Tumor Center Regensburg e.V.)
* informed consent.

Exclusion Criteria

* coordinating practitioner not implemented
* patient from district outside the study region (rural districts Regensburg, Neumarkt, Straubing, Straubing-Bogen, Kelheim, Schwandorf)
* patient unable to fill out the questionnaire for physical, psychological or language reasons (including dementia)
* age under 18 years
* pregnancy
* QoL clinician unavailable
* refusal to participate
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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German Federal Ministry of Education and Research

OTHER_GOV

Sponsor Role collaborator

Tumor Center Regensburg

OTHER

Sponsor Role lead

Responsible Party

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Ass. Prof. Dr. Monika Klinkhammer-Schalke

PD Dr.med. Monika Klinkhammer-Schalke

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Monika Klinkhammer-Schalke, MD, Ass. Prof.

Role: STUDY_CHAIR

Tumor Center Regensburg e.V., An-Institute of the University of Regensburg, Germany

Michael Koller, Ph.D., Prof.

Role: PRINCIPAL_INVESTIGATOR

Center for Clinical Trials, University Regensburg, Germany

Wilfried Lorenz, MD, Prof. Ɨ

Role: PRINCIPAL_INVESTIGATOR

Tumor Center Regensburg e.V., An-Institute of the University of Regensburg, Germany

Ferdinand Hofstädter, MD, Prof.

Role: PRINCIPAL_INVESTIGATOR

Johannes Kepler University Linz, Medical Faculty, Austria

Jeremy C Wyatt, MD, Prof.

Role: PRINCIPAL_INVESTIGATOR

Leeds Institute of Health Sciences, University of Leeds, UK

Locations

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Tumor Center Regensburg e.V., An-Institute of the University of Regensburg

Regensburg, Bavaria, Germany

Site Status

Countries

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Germany

References

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Klinkhammer-Schalke M, Koller M, Steinger B, Ehret C, Ernst B, Wyatt JC, Hofstadter F, Lorenz W; Regensburg QoL Study Group. Direct improvement of quality of life using a tailored quality of life diagnosis and therapy pathway: randomised trial in 200 women with breast cancer. Br J Cancer. 2012 Feb 28;106(5):826-38. doi: 10.1038/bjc.2012.4. Epub 2012 Feb 7.

Reference Type BACKGROUND
PMID: 22315052 (View on PubMed)

Klinkhammer-Schalke M, Koller M, Ehret C, Steinger B, Ernst B, Wyatt JC, Hofstadter F, Lorenz W; Regensburg QoL Study Group. Implementing a system of quality-of-life diagnosis and therapy for breast cancer patients: results of an exploratory trial as a prerequisite for a subsequent RCT. Br J Cancer. 2008 Aug 5;99(3):415-22. doi: 10.1038/sj.bjc.6604505.

Reference Type BACKGROUND
PMID: 18665187 (View on PubMed)

Klinkhammer-Schalke M, Koller M, Wyatt JC, Steinger B, Ehret C, Ernst B, Hofstadter F, Lorenz W. Quality of life diagnosis and therapy as complex intervention for improvement of health in breast cancer patients: delineating the conceptual, methodological, and logistic requirements (modeling). Langenbecks Arch Surg. 2008 Jan;393(1):1-12. doi: 10.1007/s00423-007-0210-5. Epub 2007 Jul 28.

Reference Type BACKGROUND
PMID: 17661076 (View on PubMed)

Klinkhammer-Schalke M, Steinger B, Koller M, Zeman F, Furst A, Gumpp J, Obermaier R, Piso P, Lindberg-Scharf P; Regensburg QoL Study Group. Diagnosing deficits in quality of life and providing tailored therapeutic options: Results of a randomised trial in 220 patients with colorectal cancer. Eur J Cancer. 2020 May;130:102-113. doi: 10.1016/j.ejca.2020.01.025. Epub 2020 Mar 13.

Reference Type DERIVED
PMID: 32179445 (View on PubMed)

Klinkhammer-Schalke M, Lindberg P, Koller M, Wyatt JC, Hofstadter F, Lorenz W, Steinger B. Direct improvement of quality of life in colorectal cancer patients using a tailored pathway with quality of life diagnosis and therapy (DIQOL): study protocol for a randomised controlled trial. Trials. 2015 Oct 14;16:460. doi: 10.1186/s13063-015-0972-y.

Reference Type DERIVED
PMID: 26467994 (View on PubMed)

Other Identifiers

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01GY1339

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

TUZ-QL-CRC-14

Identifier Type: -

Identifier Source: org_study_id