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Comparing Telephone Symptom Monitoring Interventions for Managing Symptoms and Psychological Distress During Oral Anti-Cancer Treatment
Study Purpose
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.
Recruitment Criteria
Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms
An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.
An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.
Searching Both is inclusive of interventional and observational studies.
Inclusion Criteria:
- - 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.Exclusion Criteria:
- - 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.Trial Details
This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.
Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.
Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.
Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.
Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.
The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.
The person who is responsible for the scientific and technical direction of the entire clinical study.
Category of organization(s) involved as sponsor (and collaborator) supporting the trial.
The disease, disorder, syndrome, illness, or injury that is being studied.
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 as reflected by practice personnel attitudes toward symptom management and time to address weekly IVR symptom reports; Ib. Practice personnel's actions on symptom reports (symptom-related oncology visits, oral agent treatment alterations, prescriptions of supportive care medications, referrals to supportive care services); Ic. Treatment fidelity of TIPC delivered by social workers/counselors in the ATSM+TIPC arm and time spent by them; Id. Perceptions of intervention acceptability and appropriateness for the community oncology practice.- III. Estimate the effect of the ATSM+TIPC versus active control on patient-reported financial
burden.
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 2 and 25 months later.Arms
Active Comparator: Arm I - Interactive Voice Response (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.
Experimental: Arm II - Automated Telephone Symptom Management (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 Telephone Interpersonal Counseling (TIPC) calls for up to 8 weeks. TIPC call duration is approximately 30 minutes.
Interventions
Other: - Counseling
Receive TIPC
Behavioral: - Health Education
Receive handbook
Other: - Interview
Ancillary studies
Other: - Medical Chart Review
Ancillary studies
Other: - Monitoring
Receive IVR symptom monitoring
Other: - Questionnaire Administration
Ancillary studies
Contact Information
This trial has no sites locations listed at this time. If you are interested in learning more, you can contact the trial's primary contact:
For additional contact information, you can also visit the trial on clinicaltrials.gov.
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