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CompletedNCT03396510Updated Dec 23, 2022

Electronic Symptom Monitoring Intervention for Hospitalized Patients With Cancer

An interventional study of IMPROVED intervention in Cancer, sponsored by Massachusetts General Hospital. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-12-23.

Sponsored by Massachusetts General Hospital · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
390
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This research study is evaluating a new way to deliver oncology care for patients with cancer

Read the detailed description

Patients with cancer may experience a considerable symptom burden, often requiring hospitalizations for symptom management. The study doctors want to know if daily electronic monitoring of the symptoms, such as pain, nausea, constipation, and diarrhea may improve care while participants are hospitalized.

The goal of this study is to evaluate a new way to deliver oncology care where patients' symptoms are systematically monitored during their hospital admission. The investigators are studying whether patients whose clinicians receive their patients' detailed symptom reports each day have improved symptom management compared to those whose clinicians do not receive their patients' detailed symptom reports each day.

The study will use questionnaires to measure the participant symptoms and involves participating in a study for as long as the participants are admitted to the hospital. The information the investigators collect will help them determine if electronic symptom monitoring improves the care of patients with cancer

02

Conditions studied

  • Cancer

Keywords

  • Cancer Care
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age 18 or older
  • Diagnosed with advanced cancer (defined as receiving treatment with palliative intent as per chemotherapy order entry designation, oncology clinic notes, and/or trial consent forms, or not receiving chemotherapy but followed for incurable disease as per oncology clinic notes)
  • Admitted to the oncology service at Massachusetts General Hospital
  • Verbal fluency in English

Exclusion criteria

Exclusion Criteria:

  • Unwilling or unable to participate in the study
  • Admitted electively
  • Participated during a previous admission
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
390 participants (actual)

Study arms

  • Experimental
    IMPROVED intervention

    Patients randomized to the IMPROVED intervention will self-report their symptoms each day using a tablet computer. If any patient refuses or is unable to complete the symptom assessment on the computer, the study team will permit them to use paper versions. At morning rounds each day, the clinical team will view reports detailing their patients' symptom burden. Patients randomized to IMPROVED will have their symptoms presented to their inpatient oncology team, but the study team will not provide guidance about what actions to take in response to patients' symptoms.

    Other: IMPROVED intervention

  • No intervention
    Usual Care

    Usual Care per hospital standard will be administered. Participants receiving usual care will also self-report their symptoms each day using tablet computers. However, these patients' clinicians will not receive their symptom reports.

Interventions

  • OtherIMPROVED intervention

    Patients randomized to IMPROVED will self-report their symptoms each day using a tablet computer. If any patient refuses or is unable to complete the symptom assessment on the computer, the investigators will permit them to use paper versions. At morning rounds each day, the clinical team will view reports detailing their patients' symptom burden. Patients randomized to IMPROVED will have their symptoms presented to their inpatient oncology team, but the investigators will not provide guidance about what actions to take in response to patients' symptoms.

05

What researchers measure

Primary outcomes

  1. Proportion of days with improved symptoms between study arms

    Using ESAS and PHQ symptoms, the investigators will compare the proportion of days that symptoms improved in standard care versus IMPROVED.

    Time frame: 2 years

Secondary outcomes

  1. Proportion of days with worsened symptoms between study arms

    Using ESAS and PHQ symptoms, the investigators will compare the proportion of days that symptoms worsened in standard care versus IMPROVED.

    Time frame: 2 years

  2. Change in patients' symptom scores from baseline to discharge

    Using ESAS and PHQ symptoms, the investigators will compare the average change in symptom burden for patients in standard care versus IMPROVED.

    Time frame: 2 years

  3. Hospital length of stay (measured continuously as days admitted to the hospital) between study arms

    The investigators will compare hospital length of stay (measured continuously as days admitted to the hospital) between study arms.

    Time frame: 2 years

  4. Hospital readmissions within 30 days of prior hospital discharge between study arms

    The investigators will compare readmissions within 30 days of prior hospital discharge between study arms.

    Time frame: 30 days

  5. Hospital readmissions within 90 days of prior hospital discharge between study arms

    The investigators will compare readmissions within 90 days of prior hospital discharge between study arms.

    Time frame: 90 days

Other outcomes

  1. Age as a moderator of the effect of IMPROVED on symptom burden

    The investigators will explore age as a potential moderator on the effect of IMPROVED on symptom burden.

    Time frame: 2 years

  2. Age as a moderator of the effect of IMPROVED on hospital length of stay

    The investigators will explore age as a potential moderator on the effect of IMPROVED on hospital length of stay.

    Time frame: 2 years

  3. Age as a moderator of the effect of IMPROVED on hospital readmissions

    The investigators will explore age as a potential moderator on the effect of IMPROVED on hospital readmissions.

    Time frame: 2 years

  4. Sex as a moderator of the effect of IMPROVED on symptom burden

    The investigators will explore sex as a potential moderator on the effect of IMPROVED on symptom burden.

    Time frame: 2 years

  5. Sex as a moderator of the effect of IMPROVED on hospital length of stay

    The investigators will explore sex as a potential moderator on the effect of IMPROVED on hospital length of stay.

    Time frame: 2 years

  6. Sex as a moderator of the effect of IMPROVED on hospital readmissions

    The investigators will explore sex as a potential moderator on the effect of IMPROVED on hospital readmissions.

    Time frame: 2 years

  7. Cancer type as a moderator of the effect of IMPROVED on symptom burden

    The investigators will explore cancer type as a potential moderator on the effect of IMPROVED on symptom burden.

    Time frame: 2 years

  8. Cancer type as a moderator of the effect of IMPROVED on hospital readmissions

    The investigators will explore cancer type as a potential moderator on the effect of IMPROVED on hospital readmissions.

    Time frame: 2 years

  9. Cancer type as a moderator of the effect of IMPROVED on hospital length of stay

    The investigators will explore cancer type as a potential moderator on the effect of IMPROVED on hospital length of stay.

    Time frame: 2 years

  10. Baseline symptom burden as a moderator of the effect of IMPROVED on hospital readmissions

    The investigators will explore baseline symptom burden as a potential moderator on the effect of IMPROVED on hospital readmissions.

    Time frame: 2 years

  11. Baseline symptom burden as a moderator of the effect of IMPROVED on hospital length of stay

    The investigators will explore baseline symptom burden as a potential moderator on the effect of IMPROVED on hospital length of stay.

    Time frame: 2 years

  12. Baseline symptom burden as a moderator of the effect of IMPROVED on symptom burden

    The investigators will explore baseline symptom burden as a potential moderator on the effect of IMPROVED on symptom burden.

    Time frame: 2 years

  13. Hospital length of stay as a moderator of the effect of IMPROVED on symptom burden

    The investigators will explore hospital length of stay as a potential moderator on the effect of IMPROVED on symptom burden.

    Time frame: 2 years

  14. Hospital length of stay as a moderator of the effect of IMPROVED on hospital readmissions

    The investigators will explore hospital length of stay as a potential moderator on the effect of IMPROVED on hospital readmissions.

    Time frame: 2 years

  15. Symptom burden as a mediator of the effect of IMPROVED on hospital length of stay

    The investigators will explore whether improvements in symptom burden mediate the benefit of the intervention on hospital length of stay.

    Time frame: 2 years

  16. Symptom burden as a mediator of the effect of IMPROVED on hospital readmissions

    The investigators will explore whether improvements in symptom burden mediate the benefit of the intervention on hospital readmissions.

    Time frame: 2 years

06

Study locations

1 site
  • Massachusetts General Hospital
    Boston, Massachusetts 02114, United States
07

References and documents

Publications

  • Nipp RD, Horick NK, Qian CL, Knight HP, Kaslow-Zieve ER, Azoba CC, Elyze M, Landay SL, Kay PS, Ryan DP, Jackson VA, Greer JA, El-Jawahri A, Temel JS. Effect of a Symptom Monitoring Intervention for Patients Hospitalized With Advanced Cancer: A Randomized Clinical Trial. JAMA Oncol. 2022 Apr 1;8(4):571-578. doi: 10.1001/jamaoncol.2021.7643. PubMed 35142814 ↗

Individual participant data

Plan to share: No

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Registry details

Key details

Study ID
NCT03396510
Lead sponsor
Massachusetts General Hospital
Collaborators
Alliance for Clinical Trials in Oncology Cancer Control Program (CCP)
Responsible party
Ryan Nipp (Principal Investigator, Massachusetts General Hospital) — Principal investigator
First posted
Jan 11, 2018
Start date
Feb 12, 2018
Primary completion
Jan 31, 2022
Completion
Dec 20, 2022
Last update
Dec 23, 2022

Study contacts

Ryan Nipp
principal investigator · Massachusetts General Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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