TY - JOUR
T1 - Early integrated telehealth versus in-person palliative care for patients with advanced lung cancer
T2 - A study protocol
AU - Chua, Isaac S.
AU - Zachariah, Finly
AU - Dale, William
AU - Feliciano, Josephine
AU - Hanson, Laura
AU - Blackhall, Leslie
AU - Quest, Tammie
AU - Curseen, Kimberly
AU - Grey, Carl
AU - Rhodes, Ramona
AU - Shoemaker, Laura
AU - Silveira, Maria
AU - Fischer, Stacy
AU - O'Mahony, Sean
AU - Leventakos, Kostantinos
AU - Trotter, Chardria
AU - Sereno, Isabella
AU - Kamdar, Mihir
AU - Temel, Jennifer
AU - Greer, Joseph A.
N1 - Funding Information:
This work is supported through a Patient-Centered Outcomes Research Institute (PCORI) Award (PLC-1609-35995) and by the Palliative Care Research Cooperative Group funded by the National Institute of Nursing Research U2CNR014637. No competing financial interests exist.
Publisher Copyright:
© Copyright 2019, Mary Ann Liebert, Inc., publishers 2019.
PY - 2019/9
Y1 - 2019/9
N2 - Introduction: Early palliative care (PC) integrated with oncology care improves quality of life (QOL), depression symptoms, illness understanding, and end-of-life (EOL) care for patients with advanced lung cancer. The aims of this trial are to compare the effect of delivering early integrated PC through telehealth versus in-person on patient and caregiver outcomes. We hypothesize that both modalities for delivering early PC would be equivalent for improving patient QOL, communication about EOL care preferences with their oncologist, and length of stay in hospice. Methods: For this comparative effectiveness trial, we will enroll and randomize 1250 adult patients with advanced nonsmall cell lung cancer (NSCLC), who are not being treated with curative intent, to receive either early integrated telehealth or in-person PC at 20 cancer centers throughout the United States. Patients may also invite a family caregiver to participate in the study. Patients and their caregivers in both study groups meet at least every four weeks with a PC clinician from within 12 weeks of patient diagnosis of advanced NSCLC until death. Participants complete measures of QOL, mood, and quality of communication with oncologists at baseline before randomization and at 12, 24, 36, and 48 weeks. Information on health care utilization, including length of stay in hospice, will be collected from patients' health records. To test equivalence in outcomes between study groups, we will compute analysis of covariance and mixed linear models, controlling for baseline scores and study site. Study Implementation and Stakeholder Engagement: To ensure that this comparative effectiveness trial and findings are as patient centered and meaningful as possible, we have incorporated a robust patient and stakeholder engagement plan. Our stakeholder partners include (1) patients/families, (2) PC clinicians, (3) telehealth experts and clinician users, (4) representatives from health care systems and medical insurance providers, and (5) health care policy makers and advocates. These stakeholders will inform and provide feedback about every phase of study implementation.
AB - Introduction: Early palliative care (PC) integrated with oncology care improves quality of life (QOL), depression symptoms, illness understanding, and end-of-life (EOL) care for patients with advanced lung cancer. The aims of this trial are to compare the effect of delivering early integrated PC through telehealth versus in-person on patient and caregiver outcomes. We hypothesize that both modalities for delivering early PC would be equivalent for improving patient QOL, communication about EOL care preferences with their oncologist, and length of stay in hospice. Methods: For this comparative effectiveness trial, we will enroll and randomize 1250 adult patients with advanced nonsmall cell lung cancer (NSCLC), who are not being treated with curative intent, to receive either early integrated telehealth or in-person PC at 20 cancer centers throughout the United States. Patients may also invite a family caregiver to participate in the study. Patients and their caregivers in both study groups meet at least every four weeks with a PC clinician from within 12 weeks of patient diagnosis of advanced NSCLC until death. Participants complete measures of QOL, mood, and quality of communication with oncologists at baseline before randomization and at 12, 24, 36, and 48 weeks. Information on health care utilization, including length of stay in hospice, will be collected from patients' health records. To test equivalence in outcomes between study groups, we will compute analysis of covariance and mixed linear models, controlling for baseline scores and study site. Study Implementation and Stakeholder Engagement: To ensure that this comparative effectiveness trial and findings are as patient centered and meaningful as possible, we have incorporated a robust patient and stakeholder engagement plan. Our stakeholder partners include (1) patients/families, (2) PC clinicians, (3) telehealth experts and clinician users, (4) representatives from health care systems and medical insurance providers, and (5) health care policy makers and advocates. These stakeholders will inform and provide feedback about every phase of study implementation.
KW - early palliative care
KW - lung cancer
KW - telehealth
UR - http://www.scopus.com/inward/record.url?scp=85071760715&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071760715&partnerID=8YFLogxK
U2 - 10.1089/jpm.2019.0210
DO - 10.1089/jpm.2019.0210
M3 - Article
C2 - 31486721
AN - SCOPUS:85071760715
SN - 1096-6218
VL - 22
SP - S7-S19
JO - Journal of palliative medicine
JF - Journal of palliative medicine
IS - S1
ER -