Interventions for Malignant Pleural Effusions Impact on Fatigue
NCT ID: NCT04793607
Last Updated: 2021-03-11
Study Results
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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UNKNOWN
50 participants
OBSERVATIONAL
2020-09-01
2021-10-01
Brief Summary
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Breathlessness is the most common presenting symptom of an MPE and so impact on this has previously been studied . Cancer-related fatigue is very common with evidence suggesting around 40% of patients experience fatigue at diagnosis and up to 90% during anti-cancer treatment such as radiotherapy or chemotherapy. Review of the literature suggests that whether interventions to manage MPEs can improve patient fatigue has not previously been studied.
The aim of this study is to assess if interventions for MPEs could potentially improve patient fatigue as this information will be valuable for both patients and referring health-care professionals when making the decision of whether to have a procedure or not and build on the current evidence base around management of MPEs.
The study will be part of a Masters in Clinical Research and will be within a single trust. It will be a pilot study for a potentially larger multi-center study. With this in mind, aspects of how the study runs and notes on how it could be improved upon will be carefully recorded.
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Detailed Description
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Fatigue is extreme tiredness unrelieved by rest. It is how the patient feels and so there is no specific test for it. However there are a number of tools that help record a patients self-reported fatigue levels and how this changes over time. The FACIT-fatigue tool has been studied in patients with cancer-related fatigue and has the strongest evidence base and validation in this patient group. It involves the patient answering 13 questions related to fatigue and its impact on their activities of daily living.
There are multiple contributing factors associated with malignancy-related fatigue and so consent will be gained to gather data on potential confounding factors. This will include
* Patient age
* Sex
* Patient diagnosis (site/type of cancer and whether metastatic)
* Comorbidities (esp. lung disease)
* Time since cancer diagnosis
* Time since last anti-cancer therapy/if currently having chemotherapy or radiotherapy
* BEDS\&GADS score for anxiety/depression
* Patient Outcome Score (POS) indicating whether high symptom burden
* Size of pleural effusion \& if unilateral/bilateral
* Performance status
* Blood markers- Haemoglobin level \& Creatinine
The study will involve a single pleural service in Northumbria Healthcare NHS Foundation Trust.
Both inpatients and outpatients are referred to the pleural service. They are assessed in clinic and a decision made on the most appropriate treatment of the Malignant Pleural Effusion. The study will have no impact on which intervention is chosen. Once the decision is made the patient will be asked by the doctor in clinic if they are potentially interested in being involved in the study. If they are interested then they will be seen by the researcher who will take them through the Participant Information Sheet (PIS) and give them the opportunity to ask questions. If they agree then they will be invited to provide written informed consent.
The researcher is a consultant with training in assessing patients capacity and so it will be ensured that all participants are able to give valid written consent. Those unable to give consent will be excluded from the study. Reasonable adjustments will be made to cater for patients with hearing or visual impairment.
It will be made clear that the decision to take part in the study or not will have no impact on the patient's care. It will also be explained that the patient is free to withdraw from the study at any time and under no obligation to give reason for doing so.
It will be made clear to the potential participants that taking part in the study will have no impact on their treatment. There will be no direct benefit to the participant other than for altruistic reasons such as knowing that their involvement is contributing to the research base which may improve care for patients of the future.
This study is fairly low burden as it is a short questionnaire about fatigue levels (13 questions) and permission to gather further data about the patient (age, sex, disease site, performance status, last Hb result- see list above). The participant will give permission for the researcher to telephone them to repeat the questions after 7,14 \& 30 days. The question takes less than 5 minutes to answer and so is of low burden.
There is no direct risk to staff or patient.
It is possible that the patient becomes more unwell or dies during the 30-day study period. It may therefore be upsetting to the patient or family to be contacted if this was the case. To try and avoid this then the patient's electronic records will be consulted prior to making contact via telephone. However, it may occasionally be possible that the death is not yet recorded in the electronic records and so all calls will be handled in a sensitive manner. The researcher is a Palliative Medicine consultant with advanced communication skills training and many years experience of having discussions with patients approaching the end of life as well as bereaved families.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Interventions
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Pleural procedures
Any pleural procedure that removes fluid
Eligibility Criteria
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Inclusion Criteria
* Age 18+ years
Exclusion Criteria
18 Years
ALL
No
Sponsors
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Rocket Medical plc
OTHER
Northumbria Healthcare NHS Foundation Trust
OTHER
Responsible Party
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Principal Investigators
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Donna Wakefield, MBBS
Role: PRINCIPAL_INVESTIGATOR
Northumbria Healthcare NHS Foundation Trust
Locations
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Northumbria HealthCare NHS Foundation Trust
Newcastle, , United Kingdom
Countries
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Central Contacts
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Facility Contacts
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References
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Feller-Kopman DJ, Reddy CB, DeCamp MM, Diekemper RL, Gould MK, Henry T, Iyer NP, Lee YCG, Lewis SZ, Maskell NA, Rahman NM, Sterman DH, Wahidi MM, Balekian AA. Management of Malignant Pleural Effusions. An Official ATS/STS/STR Clinical Practice Guideline. Am J Respir Crit Care Med. 2018 Oct 1;198(7):839-849. doi: 10.1164/rccm.201807-1415ST.
Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12 Suppl 1:4-10. doi: 10.1634/theoncologist.12-S1-4.
Minton O, Stone P. A systematic review of the scales used for the measurement of cancer-related fatigue (CRF). Ann Oncol. 2009 Jan;20(1):17-25. doi: 10.1093/annonc/mdn537. Epub 2008 Aug 4.
Prue G, Rankin J, Allen J, Gracey J, Cramp F. Cancer-related fatigue: A critical appraisal. Eur J Cancer. 2006 May;42(7):846-63. doi: 10.1016/j.ejca.2005.11.026. Epub 2006 Feb 7.
Provided Documents
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Document Type: Informed Consent Form
Other Identifiers
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NHCT0161
Identifier Type: -
Identifier Source: org_study_id
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