Engagement of Patients With Advanced Cancer (EPAC)

Stanford University

Status: Completed

Conditions: Melanoma; Glioblastoma Multiforme; Rectum Cancer; Colon Cancer; Head and Neck Neoplasms; Lung Neoplasm; Liver Cancer; Testicular Neoplasms; End of Life; Advanced Cancer; Gastric Cancer; Cancer of Unknown Origin; Kidney Cancer; Prostate Cancer

Treatments: Behavioral: EPAC

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT02966509

EPAC1

Details and patient eligibility

About

The Engagement of Patients with Advanced Cancer is an intervention that utilizes well-trained lay health coaches to engage patients and their families in goals of care and shared decision-making after a diagnosis of advanced cancer. Although lay health workers have never been tested in this role, we hypothesize that lay health workers can feasibly improve goals of care documentation and help to reduce unwanted healthcare utilization at the end of life for Veterans diagnosed with new advanced stages of cancer and those diagnosed with recurrent disease.

Full description

VAPAHCS proposes to implement and evaluate several critical elements to be in alignment with the VHA's Strategic Goal and priority areas for FY2013. The Engagement of Patients with Advanced Cancer project is an innovative program that will strengthen provider-patient relationship and facilitate whole person care about matters important to Veterans with cancer and important to support network and family. The project is intended to help establish Goals of Care Plan with appropriate documentation, develop, deploy, and evaluate a model of care for persons with cancer that is intended to improve clinical outcomes and experience of care for individuals with advanced cancer who have advanced cancer (stages III, IV or recurrent disease). The intervention provides patients with lay health coaches who assist patients and their families in discussing goals of care and engage in shared-decision making. The goal of the project is to demonstrate that there is improved patient experiences, outcomes, and that the program helps to reduce utilization of health care resources at the end of life.

Enrollment: 213 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Newly diagnosed stage III or IV cancer
• Recurrent disease (any stage)
• Ability to consent to study

Exclusion criteria

• Patients who are unable to consent to study procedures

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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213 participants in 2 patient groups

A: Intervention Arm

Experimental group

Description:

All participants randomized to Arm A will receive the EPAC intervention as well as usual oncologic care.

Treatment:

Behavioral: EPAC

B: Control Group Arm

No Intervention group

Description:

All participants randomized to Arm B will receive usual oncologic care.