Effects of Centering Pre-operative Counseling on Patient Reported Anxiety
|ClinicalTrials.gov Identifier: NCT04068675|
Recruitment Status : Recruiting
First Posted : August 28, 2019
Last Update Posted : March 2, 2020
|Condition or disease||Intervention/treatment||Phase|
|Gynecologic Cancer Ovarian Cancer Endometrial Cancer Uterine Cancer Cervical Cancer||Behavioral: Group pre-operative counseling||Not Applicable|
Comprehensive pre-operative counseling and education has been shown to play an important role in quality of life, anxiety and depression among cancer patients. Traditionally, patients are counseled in the office at the time of informed surgical consent. However there are several problems to this model including patient anxiety, confusion, information overload, and time constraints that may lead to sub-optimal counseling. Additionally, multiple studies have reported that patients forget half of what they have been told within 5 minutes of a health consultation and remember only 20% of the information passed on to them. Centering patient counseling has been used in other fields of medicine and has been shown to improve outcome in Obstetrics, Psychiatry, Gastroenterology, and Medical Oncology. In Obstetrics, centering pre-natal care with group counseling sessions has shown to be an effective model for improving perinatal outcomes and patient satisfaction. Pregnancy, not unlike cancer, is a medical condition that rapidly change's one life, is marred by anxiety, nervousness and innumerable potential symptoms. The rationale behind centering care is that providers can spend more time counseling and educating a larger audience at once, and it allows the whole group to benefit from individual questions, concerns, and complaints. Additionally, it establishes a network for patients to connect with other women going through similar stressors.
Prior to initiating this study, we conducted an Institutional Review Board exempt survey (STU00209351) of patients scheduled to undergo surgery with one of our Gynecologic Oncologists. Over 68% of patients expressed an interest in participating in a study to receive additional counseling. However, re-occurring themes that were mentioned were the time constraints and commuting issues in which patients experience in coming to our clinic in downtown Chicago. Given this feedback and the strong interest that our patient population has for this type of intervention, we have modified the traditional in-person centering model to an internet base, video conference group counseling session.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||50 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Supportive Care|
|Official Title:||Effects of Centering Pre-operative Counseling on Patient Reported Anxiety|
|Actual Study Start Date :||February 24, 2020|
|Estimated Primary Completion Date :||June 30, 2020|
|Estimated Study Completion Date :||June 30, 2021|
Experimental: Group counseling arm
There is only one(1) arm in this study. All patients that enroll in the study will receive the group counseling intervention and be compared to historical controls.
Behavioral: Group pre-operative counseling
Enrolled patients will participate in a group pre-operative counseling session on the online conferencing platform BlueJeans® prior to their surgery. The sessions will not replace any portion of the pre-operative standard counseling and is designed to review and re-enforce the counseling already provided. The sessions will not review or discuss the specifics of any one individual's cancer or surgery. Rather the counseling session will focus on the universal instructions provided to all patients undergoing major surgery for a known or suspected gynecologic malignancy. The sessions will be led by a physician on a weekly basis with a minimal of three (3) enrolled patients per session and last approximately one (1) hour.
- Changes in Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety survey scores [ Time Frame: It will take no more than 8 weeks to complete all survey related activities. ]The PROMIS Anxiety survey is a validated survey tool used to measure the severity of patient reported anxiety. Responses from the survey are converted to a T-score (scale: minimum score = 37.1, maximum score = 83.1) which have been standardized to the US general population with a mean 50 and standard deviation of 10. A score of less than 50 correlates to "normal" levels of anxiety, where as a score of 50-60 represents mild anxiety, 60-70 represents moderate anxiety, and >70 represents severe anxiety. PROMIS Anxiety scores will be evaluated at time of enrollment, after receiving the intervention, and four (4) weeks after surgery to evaluate for changes in anxiety scores.
- Changes in Patient-Reported Outcomes Measurement Information System (PROMIS) Depression survey scores [ Time Frame: It will take no more than 8 weeks to complete all survey related activities. ]The PROMIS Depression survey is a validated survey tool used to measure the severity of patient reported depression. Responses from the survey are converted to a T-score (scale: minimum score = 37.1, maximum score = 83.1) which have been standardized to the US general population with a mean 50 and standard deviation of 10. A score of less than 50 correlates to "normal" levels of depression, where as a score of 50-60 represents mild depression, 60-70 represents moderate depression, and >70 represents severe depression. PROMIS Depression scores will be evaluated at time of enrollment, after receiving the intervention, and four (4) weeks after surgery to evaluate for changes in depression scores.
- Hospital length of stay [ Time Frame: From surgery through study completion, an average of 4 weeks. ]The number of total days spent in the hospital after surgery until discharge
- Enhanced Recovery After Surgery (ERAS) compliance [ Time Frame: From surgery through study completion, an average of 4 weeks. ]Compliance with ERAS instructions
- Unscheduled health care resource use in the post-operative period [ Time Frame: From surgery through study completion, an average of 4 weeks. ]Use of unscheduled health care resources such as hospital re-admissions, ER visits, unscheduled clinic visits, problem-related phone calls and emails after surgery
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04068675
|Contact: Adam Pyrzak, MDfirstname.lastname@example.org|
|Contact: Emma Barber, MD, MS||312-472-4684||Emma.email@example.com|
|United States, Illinois|
|Chicago, Illinois, United States, 60611|
|Contact: Adam Pyrzak, MD|
|Principal Investigator:||Emma Barber, MD, MS||Northwestern University|