Comparing Telephone Symptom Monitoring Interventions for Managing Symptoms and Psychological Distress During Oral Anti-Cancer Treatment

NCT ID: NCT06279013

Last Updated: 2025-09-11

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

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-14

Study Completion Date

2028-05-01

Brief Summary

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In this clinical trial, symptom monitoring (interactive voice response \[IVR\] is compared to automated telephone symptom management \[ATSM\] and telephone interpersonal counseling \[TIPC\]) for reducing symptom burden and psychological distress (depressive and anxiety symptoms) among people receiving oral anti-cancer treatment. Symptoms are the number one driver of treatment interruptions and unscheduled health services use. To reduce the risk of these events, symptom monitoring and management are necessary. However, these services are not implemented routinely, especially in the community oncology settings. Further, depressive and anxiety symptoms are a key barrier to enacting symptom self-management strategies. IVR is a form of symptom monitoring where patients, when called, enter their symptom ratings over the phone. Their symptom summary is sent to their provider, and patients may be advised to reach out to their oncology provider, based on their symptoms. The ATSM intervention combines IVR assessments with a Symptom Management and Survivorship educational handbook with self-management strategies. Patients receiving ATSM enter their symptom ratings over the phone and have their symptoms reported to their provider, but patients are also directed to the handbook for strategies to manage elevated symptoms. Patients receiving ATSM who report being anxious, discouraged, or sad will also receive TIPC, which targets psychological distress and its connection to social support and interpersonal communication. Information gathered from this study may help researchers learn more about the best ways to manage patient symptoms and improve patient outcomes.

Detailed Description

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PRIMARY OBJECTIVE:

I. Test the effectiveness of Automated Telephone System Management (ATSM) + Telephone Interpersonal Counseling (TIPC) versus active control on patient-level outcome of the summary toxicity index of 24 Patient Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE) symptoms that include depressive, anxiety, and other symptoms commonly experienced during oral anti-cancer treatment over weeks 1-12 (immediate effect) and 13-17 (sustained effect).

SECONDARY OBJECTIVE:

I. Test the effectiveness of ATSM+TIPC versus active control on patient-level outcome of unscheduled health services over weeks 1-12 and 13-17.

EXPLORATORY OBJECTIVES:

I. Evaluate implementation outcomes at the practice personnel level (physicians, nurses, nurse practitioners, advanced practice providers, physician assistants, medical assistants, pharmacists, social workers, and other behavioral health professionals):

Ia. Feasibility of implementation of the automated telephone symptom monitoring and TIPC at the community oncology practice.

Ib. Perceptions of acceptability of the automated telephone symptom monitoring and TIPC for the community oncology practice.

Ic. Perceptions of appropriateness of the automated telephone symptom monitoring and TIPC for the community oncology practice.

II. Estimate delivery cost of the ATSM+TIPC and active control and cost savings for the ATSM+TIPC versus active control as a result of reduced unscheduled health services use.

III. Estimate the effect of the ATSM+TIPC versus active control on patient-reported financial burden.

IV. Estimate the differences in the effect of the ATSM+TIPC versus active control on the primary and secondary outcomes according to concurrent administration of oral agent with immune checkpoint inhibitor, other targeted infusion therapy, infusion chemotherapy, or radiation therapy.

OUTLINE: Practices are randomized to 1 of 2 arms.

ARM I: Patients receive IVR symptom monitoring calls once a week for 12 weeks, and a summary symptom report is sent to their provider. Call duration is approximately 15 minutes.

ARM II: Patients receive the Symptom Management and Survivorship handbook and receive IVR symptom monitoring calls for 12 weeks, with summary symptom reports sent to their provider. Call duration is approximately 20 minutes. Patients who report anxious, discouraged, or sad mood items on their monitoring calls for two consecutive weeks between weeks 1 and 4 also receive TIPC calls for up to 8 weeks. TIPC call duration is approximately 30 minutes.

After completion of study intervention, patients are followed up during weeks 13-17 and practice personnel are assessed at intake and 12 and 25 months later.

Conditions

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Hematopoietic and Lymphatic System Neoplasm Malignant Solid Neoplasm

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Cluster randomized
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors
Interviewers will be blinded to the study arm; IVR is automated.

Study Groups

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Arm I (IVR monitoring)

Patients receive IVR symptom monitoring calls once a week for 12 weeks, and a summary symptom report is sent to their provider. Call duration is approximately 15 minutes.

Group Type ACTIVE_COMPARATOR

Interview

Intervention Type OTHER

Ancillary studies

Medical Chart Review

Intervention Type OTHER

Ancillary studies

Monitoring

Intervention Type OTHER

Receive IVR symptom monitoring

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm II (ATSM, TIPC)

Patients receive the Symptom Management and Survivorship handbook and receive IVR symptom monitoring calls for 12 weeks, with summary symptom reports sent to their provider. Call duration is approximately 20 minutes. Patients who report anxious, discouraged, or sad mood items on their monitoring calls for two consecutive weeks between weeks 1 and 4 also receive TIPC calls for up to 8 weeks. TIPC call duration is approximately 30 minutes.

Group Type EXPERIMENTAL

Counseling

Intervention Type OTHER

Receive TIPC

Health Education

Intervention Type BEHAVIORAL

Receive handbook

Interview

Intervention Type OTHER

Ancillary studies

Medical Chart Review

Intervention Type OTHER

Ancillary studies

Monitoring

Intervention Type OTHER

Receive IVR symptom monitoring

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Interventions

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Counseling

Receive TIPC

Intervention Type OTHER

Health Education

Receive handbook

Intervention Type BEHAVIORAL

Interview

Ancillary studies

Intervention Type OTHER

Medical Chart Review

Ancillary studies

Intervention Type OTHER

Monitoring

Receive IVR symptom monitoring

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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Counseling Intervention Chart Review monitor

Eligibility Criteria

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Inclusion Criteria

* PRACTICES: All institutions participating in the practice are National Cancer Institute Community Oncology Research Program (NCORP) affiliates or sub-affiliates.
* PRACTICES: Administer oral therapy to at least 40 patients per year that meet protocol eligibility criteria.
* PRACTICES: Completion and submission of the NRG-CC012CD Letter of Intent (LOI) (posted on the Cancer Trials Support Unit \[CTSU\] website).
* PRACTICES: Having a social worker licensed in behavioral counseling or other person eligible for behavioral licensing in the practice's state or territory (if licensure is required by state or territory) who can be trained to deliver TIPC or willingness of practice to work with TIPC intervener contracted by the study team. Note: If the practice's social worker or other behavioral health professional is trained to deliver TIPC, they will be compensated for their time training and delivering the TIPC intervention.
* PRACTICE PERSONNEL: Age ≥ 18 years.
* PRACTICE PERSONNEL: Planned to be involved in usual care for at least one enrolled patient during patient's participation in the study.
* PRACTICE PERSONNEL: For a social worker or other behavioral health professional who will deliver TIPC intervention, licensure, or eligibility for licensure in behavioral counseling if required by the state or territory.
* PRACTICE PERSONNEL: The practice personnel must provide study-specific informed consent prior to study entry.
* RETAIN PRACTICE PARTICIPATION: In order to maintain participation in the study, practices must enroll at least 8 patients in the first 6 months (based upon the practice's monthly tracking reports) the practice is open to patient accrual to ensure that the practice can meet the accrual goals. If a practice does not meet this criterion they will be replaced.
* RETAIN PRACTICE PARTICIPATION: Complete monthly forms on actions taken on IVR symptom reports. If fewer than 2 forms are completed in the first 6 months of practice's participation, practice will be replaced.
* RETAIN PRACTICE PARTICIPATION: Participate in monthly study calls for the duration of practice's participation in the study.
* PATIENTS: Starting a new course of an oral anti-cancer agent (the list of agents is posted to the CTSU website) other than sex hormone inhibitors, within 4 weeks after registration or have started an oral anti-cancer agent in the past 8 weeks.
* PATIENTS: All concomitant medications and supportive care treatments are acceptable.
* PATIENTS: Age ≥ 18 years.
* PATIENTS: Able to speak and understand English or Spanish.
* PATIENTS: Access to a telephone and ability to answer questions via telephone in English or Spanish.
* PATIENTS: The patient must provide study-specific informed consent prior to study entry and authorization permitting release of personal health information.

Exclusion Criteria

* PRACTICES: Active telephone symptom management program at the practice that is beyond symptom and oral agent adherence monitoring.
* PATIENTS: Only receiving treatment with sex hormone inhibitors.
* PATIENTS: Enrollment in the intervention arm of another symptom management trial at intake into the trial. Participation in lifestyle trials with primary outcomes other than symptoms is acceptable.
* PATIENTS: Currently receiving regular behavioral counseling for psychological symptoms. Regular behavioral counseling is defined as at least two counseling sessions with a behavioral health care provider scheduled within the past two months. Patients who completed behavioral counseling within 2 months prior to registration are eligible. Behavioral counseling for issues other than psychological symptoms (e.g., as part of weight loss or smoking cessation program) is not an exclusion criterion.
* PATIENTS: Pregnancy at intake into the trial.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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NRG Oncology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Alla Sikorskii

Role: PRINCIPAL_INVESTIGATOR

NRG Oncology

Locations

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Cancer Center at Saint Joseph's

Phoenix, Arizona, United States

Site Status RECRUITING

CARTI Cancer Center

Little Rock, Arkansas, United States

Site Status RECRUITING

Phoebe Putney Memorial Hospital

Albany, Georgia, United States

Site Status RECRUITING

Augusta Oncology Associates PC-D'Antignac

Augusta, Georgia, United States

Site Status RECRUITING

Augusta University Medical Center

Augusta, Georgia, United States

Site Status RECRUITING

Queen's Cancer Cenrer - POB I

Honolulu, Hawaii, United States

Site Status RECRUITING

Queen's Medical Center

Honolulu, Hawaii, United States

Site Status RECRUITING

Queen's Cancer Center - Kuakini

Honolulu, Hawaii, United States

Site Status RECRUITING

The Queen's Medical Center - West Oahu

‘Ewa Beach, Hawaii, United States

Site Status RECRUITING

John H Stroger Jr Hospital of Cook County

Chicago, Illinois, United States

Site Status RECRUITING

Carle at The Riverfront

Danville, Illinois, United States

Site Status RECRUITING

Carle Physician Group-Effingham

Effingham, Illinois, United States

Site Status RECRUITING

Carle Physician Group-Mattoon/Charleston

Mattoon, Illinois, United States

Site Status RECRUITING

Carle Cancer Center

Urbana, Illinois, United States

Site Status RECRUITING

Central Care Cancer Center - Garden City

Garden City, Kansas, United States

Site Status RECRUITING

University Medical Center New Orleans

New Orleans, Louisiana, United States

Site Status RECRUITING

Lake Regional Hospital

Osage Beach, Missouri, United States

Site Status RECRUITING

University of New Mexico Cancer Center

Albuquerque, New Mexico, United States

Site Status RECRUITING

AnMed Health Cancer Center

Anderson, South Carolina, United States

Site Status RECRUITING

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status RECRUITING

Prisma Health Cancer Institute - Butternut

Greenville, South Carolina, United States

Site Status RECRUITING

Prisma Health Cancer Institute - Faris

Greenville, South Carolina, United States

Site Status RECRUITING

Prisma Health Greenville Memorial Hospital

Greenville, South Carolina, United States

Site Status RECRUITING

Prisma Health Cancer Institute - Eastside

Greenville, South Carolina, United States

Site Status RECRUITING

Langlade Hospital and Cancer Center

Antigo, Wisconsin, United States

Site Status RECRUITING

Aspirus Medford Hospital

Medford, Wisconsin, United States

Site Status RECRUITING

Aspirus Cancer Care - James Beck Cancer Center

Rhinelander, Wisconsin, United States

Site Status RECRUITING

Aspirus Cancer Care - Stevens Point

Stevens Point, Wisconsin, United States

Site Status RECRUITING

Aspirus Regional Cancer Center

Wausau, Wisconsin, United States

Site Status RECRUITING

Aspirus Cancer Care - Wisconsin Rapids

Wisconsin Rapids, Wisconsin, United States

Site Status RECRUITING

Puerto Rico Hematology Oncology Group

Bayamón, , Puerto Rico

Site Status RECRUITING

Doctors Cancer Center

Manatí, , Puerto Rico

Site Status RECRUITING

Centro Comprensivo de Cancer de UPR

San Juan, , Puerto Rico

Site Status RECRUITING

PROncology

San Juan, , Puerto Rico

Site Status RECRUITING

Countries

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United States Puerto Rico

Facility Contacts

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Site Public Contact

Role: primary

720-874-1881

Site Public Contact

Role: primary

501-906-4199

Site Public Contact

Role: primary

229-312-0405

Site Public Contact

Role: primary

706-821-2944

Site Public Contact

Role: primary

706-721-2388

Site Public Contact

Role: primary

808-532-0315

Site Public Contact

Role: primary

808-545-8548

Site Public Contact

Role: primary

808-531-8521

Site Public Contact

Role: primary

Site Public Contact

Role: primary

312-864-5204

Site Public Contact

Role: primary

800-446-5532

Site Public Contact

Role: primary

800-446-5532

Site Public Contact

Role: primary

800-446-5532

Site Public Contact

Role: primary

800-446-5532

Site Public Contact

Role: primary

913-948-5588

Site Public Contact

Role: primary

504-210-3539

Site Public Contact

Role: primary

573-302-2768

Site Public Contact

Role: primary

505-925-0348

Site Public Contact

Role: primary

864-512-4651

Site Public Contact

Role: primary

843-792-9321

Site Public Contact

Role: primary

864-522-4317

Site Public Contact

Role: primary

864-522-4317

Site Public Contact

Role: primary

864-522-4317

Site Public Contact

Role: primary

864-522-4317

Site Public Contact

Role: primary

715-623-9869

Site Public Contact

Role: primary

715-847-2353

Site Public Contact

Role: primary

715-847-2353

Site Public Contact

Role: primary

715-847-2353

Site Public Contact

Role: primary

877-405-6866

Site Public Contact

Role: primary

715-422-7718

Site Public Contact

Role: primary

787-780-2865

Site Public Contact

Role: primary

787-621-4397

Site Public Contact

Role: primary

412-339-5294

Site Public Contact

Role: primary

787-919-7919

Other Identifiers

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NCI-2023-10831

Identifier Type: REGISTRY

Identifier Source: secondary_id

NRG-CC012CD

Identifier Type: OTHER

Identifier Source: secondary_id

NRG-CC012CD

Identifier Type: OTHER

Identifier Source: secondary_id

NRG-CC012CD

Identifier Type: OTHER

Identifier Source: secondary_id

R01CA279472

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1CA189867

Identifier Type: NIH

Identifier Source: secondary_id

View Link

NRG-CC012CD

Identifier Type: -

Identifier Source: org_study_id

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