A Collaborative Intervention for Improving Cancer Pain Management in Rural and Hispanic Cancer Survivors (ASCENT)

NCT ID: NCT06198010

Last Updated: 2025-11-10

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

RECRUITING

Clinical Phase

NA

Total Enrollment

660 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-07

Study Completion Date

2027-08-31

Brief Summary

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This clinical trial tests a collaborative pain management intervention (ASCENT) for improving cancer pain in rural and Hispanic cancer survivors. Cancer pain is prevalent, under-treated, and remains a major cause of suffering, impairment, and disability for millions of Americans. Individual pain interventions and care models show promise for cancer pain in controlled settings. Hispanic and rural-dwelling cancer survivors stand to benefit the most from electronic health record innovations, as each of these health disparities populations experience profound disparities in pain outcomes, including marked under- and over-prescribing of opioids. Digitally facilitated solutions are especially well matched for these patients, and can be customized to address their needs. The ASCENT intervention provides patients with an educational guide that describes techniques for addressing cancer pain, and uses community health workers and pain care managers to coach patients through a personalized pain management plan. This study may help researchers learn how pain management strategies can improve cancer pain and lower risk of opioid exposure and dependency in rural and Hispanic cancer survivors.

Detailed Description

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NOTE: Although Mayo Clinic in Arizona, Mayo Clinic in Florida, and Mayo Clinic in Rochester are the main study locations, this study is also recruiting (enrolling remotely) at the following Mayo Clinic Health System locations. The study is virtual/remote, so no travel is required.

Mayo Clinic Health Systems-Mankato Mankato, MN 56001, US

Mayo Clinic Health System in Albert Lea Albert Lea, MN 56007, US

Mayo Clinic Health System in Austin Austin, MN 55912, US

Mayo Clinic Health System-Eau Claire Clinic Eau Claire, WI 54701, US

Mayo Clinic Health System-Franciscan Healthcare La Crosse, WI 54601, US

PRIMARY OBJECTIVE:

I. To test a validated collaborative care model-based intervention aimed at improving pain control among rural dwelling and Hispanic cancer survivors by promoting multimodal pain care (MMPC) to reduce inappropriate opioid use and by addressing social determinants of health (SDOH) that impede a patient's access to appropriate care.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive enhanced usual care, which includes access to the educational and pain self-management materials developed for the ASCENT trial (the ASCENT guide).

ARM II: Patients receive the ASCENT guide and attend 3 video or phone calls over 30 minutes each with their community health worker (CHW) and/or pain care manager (PCM). During the first call, patients discuss barriers to receiving help for their pain with their CHW. During the second call, patients work with their PCM to develop an action plan for addressing their pain using the different techniques and interventions detailed in the ASCENT guide. During the third and final call, patients meet with both their CHW and PCM to discuss specialist recommendations for their pain management plan. After the final visit, patients will be contacted by the CHW or PCM every other week to monitor their progress and may also be contacted as-needed based on the their reported pain intensity, symptoms, or reported barriers.

Conditions

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Hematopoietic and Lymphoid System Neoplasm Malignant Solid Neoplasm Hematopoietic and Lymphatic System Neoplasm

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors
Patient Reported Outcome Measures will be administered at baseline by a study coordinator and at 3 and 6 months by a blinded, bilingual, assessor.

Study Groups

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Arm I (enhanced usual care)

Patients receive enhanced usual care, which includes access to the educational and pain self-management materials developed for the ASCENT trial (the ASCENT guide).

Group Type ACTIVE_COMPARATOR

Best Practice

Intervention Type OTHER

Receive enhanced usual care

Educational Intervention

Intervention Type OTHER

Receive ASCENT guide

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Electronic Health Record Review

Intervention Type OTHER

Ancillary studies

Arm II (ASCENT intervention)

Patients receive the ASCENT guide and attend 3 video or phone calls over 30 minutes each with their CHW and/or PCM. During the first call, patients discuss barriers to receiving help for their pain with their CHW. During the second call, patients work with their PCM to develop an action plan for addressing their pain using the different techniques and interventions detailed in the ASCENT guide. During the third and final call, patients meet with both their CHW and PCM to discuss specialist recommendations for their pain management plan. After the final visit, patients will be contacted by the CHW or PCM every other week to monitor their progress and may also be contacted as-needed based on the their reported pain intensity, symptoms, or reported barriers.

Group Type EXPERIMENTAL

Best Practice

Intervention Type OTHER

Receive enhanced usual care

Educational Intervention

Intervention Type OTHER

Receive ASCENT guide

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Electronic Health Record Review

Intervention Type OTHER

Ancillary studies

Health Telemonitoring

Intervention Type PROCEDURE

Attend video or phone calls with a CHW and/or PCM

Cancer Pain Management

Intervention Type BEHAVIORAL

Receive personalized pain management plan

Interventions

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Best Practice

Receive enhanced usual care

Intervention Type OTHER

Educational Intervention

Receive ASCENT guide

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Electronic Health Record Review

Ancillary studies

Intervention Type OTHER

Health Telemonitoring

Attend video or phone calls with a CHW and/or PCM

Intervention Type PROCEDURE

Cancer Pain Management

Receive personalized pain management plan

Intervention Type BEHAVIORAL

Other Intervention Names

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standard of care standard therapy Education for Intervention Intervention by Education Intervention through Education Intervention, Educational management of cancer pain

Eligibility Criteria

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Inclusion Criteria

* A qualifying liquid or solid cancer diagnosis with visits at a participating Mayo site in the past 15 years

* Including malignant hematology

* Lymphoma
* Myeloma
* Chronic leukemias
* Age \>= 18
* Numeric Rating Scale (NRS) pain score of \>= 5/10
* Pain that developed or worsened following cancer diagnosis
* Fit the description of either rural or Hispanic or both

Exclusion Criteria

* Patient Health Questionnaire - 8 (PHQ8) score of \>= 13
* Hospice enrollment
* Skilled nursing facility, inpatient rehabilitation facility, or long-term care placement
* Encounters with Palliative Care or the Pain Clinic in the past two months or upcoming two months
* Any mention of hospice referral in medical oncology encounter notes (assess through textual search of the Mayo Data Explorer)
* Affirmative response to, "Are you usually confined to a bed or chair more than a third of your waking hours because of your health?"
* Currently homeless
* Do not feel safe in their home
* New or worsening chest pain, chest tightness, or chest pressure
* Back pain that is associated with a new or worsening weakness, control of bowels/bladder, or difficulty walking
* Lightheadedness, inability to keep down food or fluids, or vomiting blood or dark coffee-grounds-like material
* New or worsening headaches that are associated with vision changes, nausea, balance issues, or problems with speech
* Screens positive for use of non-cannabis drug use a a frequency of monthly or greater
* Inability to engage with the intervention due to medical or psychological reasonse
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Andrea L. Cheville, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic in Rochester

Locations

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Mayo Clinic in Arizona

Scottsdale, Arizona, United States

Site Status RECRUITING

Mayo Clinic in Florida

Jacksonville, Florida, United States

Site Status RECRUITING

Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Clinical Trials Referral Office

Role: CONTACT

Phone: 507-293-1043

Email: [email protected]

Josiah Lulf

Role: CONTACT

Phone: 507-538-7991

Email: [email protected]

Facility Contacts

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Clinical Trials Referral Office

Role: primary

Clinical Trials Referral Office

Role: primary

Clinical Trials Referral Office

Role: primary

Josiah Lulf

Role: backup

Provided Documents

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Document Type: Study Protocol

View Document

Related Links

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Other Identifiers

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R33CA278594

Identifier Type: NIH

Identifier Source: secondary_id

View Link

23-010838

Identifier Type: OTHER

Identifier Source: secondary_id

ASCENT_MAIN

Identifier Type: -

Identifier Source: org_study_id