International Study to Evaluate a Navigation Program for Older People With Cancer and Their Family Caregivers (EU NAVIGATE Study)

NCT ID: NCT06110312

Last Updated: 2023-10-31

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

489 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-15

Study Completion Date

2026-05-31

Brief Summary

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Most people with cancer are older, and this affects millions of Europeans yearly. Integrating high-quality, equitable, and cost-effective care across the continuum of supportive, palliative, and end-of-life care for both patients and family caregivers is highly relevant from a healthcare, prevention, and economic perspective.

EU NAVIGATE is an interdisciplinary, cross-country, and intersectoral project funded by the European Union. The overall aim of the study is to evaluate the effectiveness and cost-effectiveness of a patient and family navigation intervention (NavCare-EU) for older people with cancer and declining health and their family caregivers in different healthcare systems in Europe. Nav-Care EU is a person- and family-centered non-pharmacological intervention in which navigators collaborate with patients and families to improve quality of life and improve levels of social support, foster empowerment, and facilitate timely and equitable access to health and social care services and resources as needed, throughout the supportive and palliative care continuum. NavCare-EU is based on the existing and successfully tested Nav-CARE(c) intervention from Canada.

Effectiveness and cost-effectiveness will be evaluated through an international 6-country multisite pragmatic fast-track randomised controlled trial (RCT) with an embedded mixed methods process evaluation to compare the NavCare-EU intervention in addition to standard care with the provision of standard care alone. The RCT and process evaluation will be conducted in Belgium (Flanders), Ireland, Italy, the Netherlands, Poland, and Portugal. Participants are people with cancer and declining health, who are aged 70 years and older, as well as their close family caregivers.

Specific objectives are:

1\. To compare the NavCare-EU intervention to care as usual, in terms of its:

1. Effectiveness on (1) global health status/quality of life, and the levels of social support (two co-primary outcomes); and on feelings of loneliness of older persons with cancer across the continuum of supportive, palliative, and end-of-life care; (2) family caregiver burden
2. cost-effectiveness
3. effects on different subgroups defined by characteristics known to affect health equity and equitable access, i.e., gender, age, socioeconomic status, extent of social support and living situation, and geographical location (rural vs. urban)
4. effectiveness and cost-effectiveness in different health care systems and care regimes in Europe

2\. To evaluate the implementation processes of the NavCare-EU intervention and the feasibility of its integration in different health care systems and care regimens in Europe, the contextual barriers and facilitators for effective and sustainable implementation, and the mechanisms involved in reaching the outcomes in each country, as perceived by patients, family caregivers, and other care providers

Detailed Description

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Conditions

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Cancer (Active Cancer, Meaning Not Being Cancer Free), of Any Stage and Involving Any Treatment/Care Regimen; i.e. Curative, Life-extending, or Palliative

Keywords

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palliative care supportive care cancer family caregiver older people community primary care

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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intervention group

In EU NAVIGATE, participants in the intervention group will receive a navigation intervention (also called NavCare-EU), alongside any usual care. Navcare-EU is a person- and family-centered navigation intervention, aimed at supporting older people with cancer throughout the care and illness continuum, via the involvement of a patient/family navigator. Navigators focus on connecting clients to social supports, both formal and informal, advocating for clients in meeting their quality-of-life goals, resourcing by identifying needs and negotiating access to meeting those needs, and engaging clients in what is most meaningful to them. Navigators are selected, trained, and mentored volunteers or professionals. NavCare-EU is based on the existing and successfully tested Nav-CARE(c) intervention from Canada.

Group Type EXPERIMENTAL

NavCare-EU

Intervention Type BEHAVIORAL

NavCare-EU is a person- and family-centered intervention in which navigators collaborate with older persons and their close family caregivers across the continuum of supportive, palliative, and end-of-life care,. NavCare-EU is based on the existing and successfully tested Nav-CARE intervention from Canada. Navigators focus on connecting clients to social supports, both formal and informal, advocating for clients in meeting their quality-of-life goals, resourcing by identifying needs and negotiating access to meeting those needs, and engaging clients in what is most meaningful to them. Navigators are selected, trained, and mentored volunteers or professionals. NavCare-EU is based on the existing and successfully tested Nav-CARE(c) intervention from Canada.

control group

Participants in the control group will receive what is usual care in each of the participating countries for 24 weeks (primary trial outcome). After 24 weeks, they will also receive the navigation intervention (NavCare-EU) (fast-track RCT).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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NavCare-EU

NavCare-EU is a person- and family-centered intervention in which navigators collaborate with older persons and their close family caregivers across the continuum of supportive, palliative, and end-of-life care,. NavCare-EU is based on the existing and successfully tested Nav-CARE intervention from Canada. Navigators focus on connecting clients to social supports, both formal and informal, advocating for clients in meeting their quality-of-life goals, resourcing by identifying needs and negotiating access to meeting those needs, and engaging clients in what is most meaningful to them. Navigators are selected, trained, and mentored volunteers or professionals. NavCare-EU is based on the existing and successfully tested Nav-CARE(c) intervention from Canada.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Have a cancer diagnosis (active cancer, meaning not being cancer free, of any stage and involving any treatment/care regimen; i.e. curative, life-extending, or palliative), AND
* Aged 70 years or over, AND
* Have declining or deteriorating health using the Clinical Frailty Scale, AND
* Live at home (own home or home of the family caregiver) (or discharged home if recruited in hospital), AND
* Live within the catchment area of the navigation programme/service


* Aged 18 years or over , AND
* Lives with the person with cancer OR provides care at least on a weekly basis, AND
* Identified as primary family caregiver by the older person with cancer

Exclusion Criteria

* The close family caregiver living with the person with cancer or providing care at least on a weekly basis, and identified as the primary family caregiver by the person with cancer, if present, does not agree to participate in the study (unless participation is explicitly requested by the patient) , OR
* Lives in a care or nursing home, or is incarcerated, OR
* Currently receives care from a formally recognized community-based multidisciplinary or specialist palliative care team, OR
* Is unable to provide informed consent or has difficulties understanding the information about the study , OR
* Has a psychiatric condition (i.e. schizophrenia, bipolar disorder, or major depressive disorder) OR has an active substance abuse disorder OR
* Is not able to participate in data collection in the country's language

For close family caregiver (if present)


* Is unable to provide informed consent or has difficulties understanding the information about the study, OR
* Is not able to participate in data collection in the country's language
Minimum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Dublin, Trinity College

OTHER

Sponsor Role collaborator

Uniwersytet Jagiellonski

UNKNOWN

Sponsor Role collaborator

Amsterdam UMC, location VUmc

OTHER

Sponsor Role collaborator

University of Coimbra

OTHER

Sponsor Role collaborator

University Ghent

OTHER

Sponsor Role collaborator

University of British Columbia

OTHER

Sponsor Role collaborator

Lega Italiana per la Lotta contro i Tumori

OTHER

Sponsor Role collaborator

Vrije Universiteit Brussel

OTHER

Sponsor Role lead

Responsible Party

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Lieve Van den Block

Professor of ageing and palliative care

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lieve Van den Block, PhD

Role: PRINCIPAL_INVESTIGATOR

Vrije Universiteit Brussel

Central Contacts

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Lieve Van den Block, PhD

Role: CONTACT

Phone: +3224774310

Email: [email protected]

Tinne Smets, PhD

Role: CONTACT

Phone: +3224774755

Email: [email protected]

References

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Smets T, Pivodic L, Miranda R, Van Campe F, Vinckier C, Pesut B, Duggleby W, Davies AN, Lavan A, May P, Gomes B, Furlan de Brito M, Rodrigues V, Szczerbinska K, Kijowska V, Baranska I, De Buyser S, Ferraris D, Alfieri S, Scacciati B, Du Cheyne H, Chambaere K, Gilissen J, van der Plas AGM, Pasman RH, Onwuteaka-Philipsen BD; EU NAVIGATE; Van den Block L. Implementation and evaluation of a navigation program for people with cancer in old age and their family caregivers: study protocol for the EU NAVIGATE International Pragmatic Randomized Controlled Trial. Trials. 2024 Nov 27;25(1):800. doi: 10.1186/s13063-024-08633-5.

Reference Type DERIVED
PMID: 39605055 (View on PubMed)

Other Identifiers

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101057361

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

1432023000143

Identifier Type: -

Identifier Source: org_study_id