PRIORITY-CONNECT 2 Pilot Trial

NCT ID: NCT06212700

Last Updated: 2024-04-25

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

RECRUITING

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-12

Study Completion Date

2025-12-22

Brief Summary

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The provision of preoperative interventions (prehabilitation: including exercise, nutrition, and psychological treatment) have been reported to reduce postoperative complications by as much as 50% and reduce hospital stay by up to 4 days compared to standard of care. Postoperative multimodal interventions are likely to further benefit patients facing new challenges (e.g. stoma care), and reduce post discharge complications.

Therefore the Virtual Multimodal hub of PRIORITY-CONNECT 2 Pilot Trial aims to primarily; determine the feasibility of incorporating a virtual multimodal program into the preoperative and postoperative period for patients undergoing gastrointestinal cancer surgery, the acceptability to patients, clinicians and carers of the virtual multimodal program and the acceptability to patients of being randomised to the virtual multimodal program or usual care.

The secondary aim is to obtain pilot data on the likely difference in key outcomes (30 days postoperative complications, quality of life, days at home and alive at 30 days - DAH30, implementation outcomes and cost outcomes) to inform the development of a substantive randomised clinical trial.

Detailed Description

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Conditions

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Liver Cancer Pancreas Cancer Oesophageal Cancer Gastric Cancer Colorectal Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomised Type I Hybrid Effectiveness-Implementation Trial
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Consenting participants will undergo baseline assessment immediately prior to randomisation to intervention (virtual multimodal hub and usual care) or control group (usual care alone). The randomisation sequence will be prepared a priori using a central secure randomisation service (1:1 allocation ratio in random permuted blocks of sizes 4 or 2 stratified by hospital, to ensure balance intreatment assignment within hospital) to ensure concealment of treatment allocation and blinding of surgeon, all trial personnel and statistician. Due to the nature of the intervention, it is not possible to blind the clinicians delivering the intervention (virtual multimodal hub); however, the investigators will ensure that all patients' interactions are standardised.

Study Groups

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Virtual Multimodal Hub and usual care (Intervention Group)

The main aim of the virtual multimodal hub is to prepare participants for surgery (including the role of Enhanced Recovery after Surgery (ERAS) pathway) and support declines in physiological and psychological function associated with preoperative treatments (e.g., chemo-radiotherapy) and major surgery. The post-hospital discharge interventions will focus on the recovery of activities of daily living, occupational tasks, and recreational activities. Aided by standardised assessment tools, a comprehensive holistic baseline (first preoperative multimodal session) and post-discharge (first postoperative multimodal session) assessment of patients' physical, nutritional, psychological and overall health status, presence of co-morbidities and medical history will determine the frequency, intensity, time, type, volume, and progression of the multimodal interventions.

Group Type EXPERIMENTAL

Preoperative Exercise

Intervention Type BEHAVIORAL

Aerobic (HIIT) Endurance Respiratory Muscle Strength Education

Postoperative Exercise

Intervention Type BEHAVIORAL

Aerobic Muscle Strength Walking Program Education

Preoperative Nutrition

Intervention Type DIETARY_SUPPLEMENT

Malnutrition screening Weight monitoring Symptom management Dietetic counselling Nutrition support

Postoperative Nutrition

Intervention Type DIETARY_SUPPLEMENT

Malnutrition screening Weight monitoring Symptom management Dietetic counselling Nutrition support

Preoperative Psychology

Intervention Type BEHAVIORAL

CBT skills Skills training Emotional validation Behavioural activation Psycho-education

Postoperative Psychology

Intervention Type BEHAVIORAL

CBT skills Skills training Emotional validation Behavioural activation Psycho-education

Preoperative Nursing

Intervention Type OTHER

Comorbidities Managing pain Wound care Complications Surgical education ERAS

Postoperative Nursing

Intervention Type OTHER

Managing pain Cardiovascular stability Wound care Bowel function/Stoma Complications Education

Preoperative Peer Support Group

Intervention Type OTHER

Weekly sessions moderated by a social worker including patients and carers:

Safe space Share experiences/ideas Support Education

Postoperative Peer Support Group

Intervention Type OTHER

Weekly sessions moderated by a social worker including patients and carers:

Safe space Share experiences/ideas Support Education

Usual Care

Intervention Type OTHER

Participants allocated to the control group will receive usual care according to their health care team, which may consist of advice on smoking cessation, reduction of alcohol intake, nutritional counselling, and medical optimisation in the preoperative anaesthetic clinic visits.

Usual care alone (Control Group)

Participants allocated to the control group will receive usual care according to their health care team, which may consist of advice on smoking cessation, reduction of alcohol intake, nutritional counselling, and medical optimisation in the preoperative anaesthetic clinic visits. Participants will be asked to maintain their normal daily activities.

Group Type ACTIVE_COMPARATOR

Usual Care

Intervention Type OTHER

Participants allocated to the control group will receive usual care according to their health care team, which may consist of advice on smoking cessation, reduction of alcohol intake, nutritional counselling, and medical optimisation in the preoperative anaesthetic clinic visits.

Interventions

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Preoperative Exercise

Aerobic (HIIT) Endurance Respiratory Muscle Strength Education

Intervention Type BEHAVIORAL

Postoperative Exercise

Aerobic Muscle Strength Walking Program Education

Intervention Type BEHAVIORAL

Preoperative Nutrition

Malnutrition screening Weight monitoring Symptom management Dietetic counselling Nutrition support

Intervention Type DIETARY_SUPPLEMENT

Postoperative Nutrition

Malnutrition screening Weight monitoring Symptom management Dietetic counselling Nutrition support

Intervention Type DIETARY_SUPPLEMENT

Preoperative Psychology

CBT skills Skills training Emotional validation Behavioural activation Psycho-education

Intervention Type BEHAVIORAL

Postoperative Psychology

CBT skills Skills training Emotional validation Behavioural activation Psycho-education

Intervention Type BEHAVIORAL

Preoperative Nursing

Comorbidities Managing pain Wound care Complications Surgical education ERAS

Intervention Type OTHER

Postoperative Nursing

Managing pain Cardiovascular stability Wound care Bowel function/Stoma Complications Education

Intervention Type OTHER

Preoperative Peer Support Group

Weekly sessions moderated by a social worker including patients and carers:

Safe space Share experiences/ideas Support Education

Intervention Type OTHER

Postoperative Peer Support Group

Weekly sessions moderated by a social worker including patients and carers:

Safe space Share experiences/ideas Support Education

Intervention Type OTHER

Usual Care

Participants allocated to the control group will receive usual care according to their health care team, which may consist of advice on smoking cessation, reduction of alcohol intake, nutritional counselling, and medical optimisation in the preoperative anaesthetic clinic visits.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adults aged ≥18 years undergoing major gastrointestinal elective surgery, including liver, pancreas, oesophagus, gastric and colorectal cancer resections with curative intent
* Consulting with a gastrointestinal cancer surgeon at least 1 week prior to scheduled surgery

Exclusion Criteria

* Cognitive impairment such that they are unable to provide informed consent
* No access to a smart device (including mobile phone, tablet, laptop or desk computer with camera) or no internet connection
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Surgical Outcomes Research Centre (SOuRCe)

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Chris O'Brien Lifehouse

Sydney, New South Wales, Australia

Site Status RECRUITING

Royal Prince Alfred Hospital, Surgical Outcomes Research Centre (SOuRCe)

Sydney, New South Wales, Australia

Site Status RECRUITING

Countries

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Australia

Central Contacts

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Daniel Steffens, PhD

Role: CONTACT

+61 02 9515 3203

Facility Contacts

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Michael Solomon, DMed

Role: primary

+61 02 95153200

Daniel Steffens, PhD

Role: primary

+61 02 9515 3203

Other Identifiers

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X23-0399

Identifier Type: -

Identifier Source: org_study_id

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