Integrating Palliative Care and Modern Palliative Care Tools Into the Care of Patients With Pancreas Cancer (iPC3)
The main purpose of this study is to evaluate the acceptance by patients with metastatic pancreas cancer of integrating palliative care with usual cancer treatment. Palliative care intervention will involve use of pancreas cancer-specific decision aides (iPC3)about prognosis, treatment choices, and advance care planning for patients facing a treatment decision as well as symptom assessments. We hypothesize that palliative care consultations with iPC3 will be accepted, symptoms can be diminished, information can be received in a way that improves choices, and that the quality of care can be improved.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||iPC3 - Integrating Palliative Care and Modern Palliative Care Tools Into the Care of Patients With Pancreas Cancer|
- Feasibility of the patients with metastatic pancreas cancer to meet with the palliative care team and to complete symptom assessments. [ Time Frame: participants will be followed monthly until referred to hospice or until death, an expected average of 1 year ] [ Designated as safety issue: No ]
- Changes in symptoms listed in the Memorial Symptom Assessment Scale (condensed version) [ Time Frame: participants will be followed monthly until referred to hospice or until death, an expected average of 1 year ] [ Designated as safety issue: No ]The condensed Memorial Symptom Assessment Scale evaluates 14 symptoms: lack of energy, lack of appetite, pain, dry mouth, weight loss, feeling drowsy, shortness of breath, constipation, difficulty sleeping, difficulty concentrating, nausea, worrying, feeling sad, and feeling nervous.
- Changes in the use of wills, living wills, advanced medical directives, durable power of medical attorney and preferred place of death. [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Changes in hospice referral, use, acceptance, and length of stay, compared to similar patients in the prior 12 months (from retrospective review) [ Time Frame: 1 year ] [ Designated as safety issue: No ]
|Study Start Date:||March 2013|
|Estimated Study Completion Date:||March 2015|
|Estimated Primary Completion Date:||March 2014 (Final data collection date for primary outcome measure)|
palliative care with iPC3
Palliative care with decision aids will be administered at each palliative care visit.
Other: Palliative care with decision aids
Participant is followed by the palliative care team, and at each visit, patient will assess their distress and symptoms. Patients facing a treatment decision will receive a Patient Information Program link to review the diagnosis, prognosis, specific benefits and risks with the proposed chemotherapy.
- Each patient undergoing treatment at Johns Hopkins for metastatic pancreas cancer will receive palliative care support during their course to include: palliative care consultation early in their treatment course; patient decision aids that give survival, treatment benefits and risks; suggestions to complete such tasks as advance directives, durable power of medical attorney, wills, family and spiritual reviews as recommend by the American Society of Clinical Oncology; and when indicated, transition to hospice.
- Patient will have an iPad for their visit, and a corresponding website to print information.
- Each patient will assess their distress with the Distress thermometer; symptoms with the Condensed Memorial Symptom Assessment Scale and a depression screen. This information will be given to the health care practitioner before the patient visit.
- Patients facing a treatment decision will receive a Patient Information Program link (or paper for those unable to work on the iPad) to review the diagnosis, prognosis, specific benefits and risks with the proposed chemotherapy. This will then give transition "prompts" to encourage thinking about advance directives, durable power of medical attorney, use of hospice, and doing a life review.
- We will also offer a hospice information visit when patient has - in the projection of the team or treating physician - 3 to 6 months to live.
- The palliative care team will meet at least monthly with each of the enrolled patients.
- Participants will be followed for as long as he or she is alive before receiving hospice care.
|Contact: Thomas J Smith, MDfirstname.lastname@example.org|
|Contact: Mok-Chung J Cheng, MD||410 955 email@example.com|
|United States, Maryland|
|Sidney Kimmel Comprehensive Cancer Center||Not yet recruiting|
|Baltimore, Maryland, United States, 21287-0005|
|Contact: Thomas J Smith, MD 410-955-2091 firstname.lastname@example.org|
|Principal Investigator:||Thomas J Smith, MD||Johns Hopkins Medical Institutions, Sidney Kimmel Comprehensive Cancer Center|