Improving Processes of Cancer Care Delivery at a Comprehensive Cancer Center

M.D. Anderson Cancer Center

Status

Not yet enrolling

Conditions

Metastatic Malignant Solid Neoplasm

Treatments

Other: Questionnaire Administration

Procedure: Discussion

Other: Electronic Health Record Review

Study type

Observational

Funder types

Other

NIH

Identifiers

NCT05095948

NCI-2021-10266 (Registry Identifier)

2020-0246 (Other Identifier)

Details and patient eligibility

About

This study examines how cancer care is delivered in oncology and supportive care clinics. Collecting patient feedback may help doctors better understand the processes of cancer care in oncology and supportive care clinics.

Full description

PRIMARY OBJECTIVES:

I. To compare the total amount of follow-up clinic time spent on discussing supportive/palliative care issues between primary palliative care provided by the oncology team and specialist palliative care.

SECONDARY OBJECTIVES:

I. To compare between the specialist palliative care team and the oncology team the following aspects of supportive/palliative care delivery: Ia. The number of supportive/palliative care needs the patient reported before the clinic visit (SPARC).

Ib. The number of supportive/palliative care needs the patient wanted to discuss with the clinical team before the clinic visit (SPARC).

Ic. The number of supportive/palliative care needs that were actually raised by the patient during the clinic visit (audiotape).

Id. The number of supportive/palliative care needs that were actually discussed by the clinical team during clinic visit (audiotape).

Ie. The number of supportive/palliative care needs that were documented in progress note by the clinical team after each visit (electronic health record).

If. The number of supportive/palliative care needs that the patient reported had been adequate addressed after the clinic visit (SPARC).

II. To compare the amount of clinic time (both absolute and proportion) spent on discussing supportive/palliative care issues by individual disciplines (e.g. medical doctor, registered nurse, counselor, pharmacist, psychologist, social worker, and priest) between the specialist palliative care team and the oncology team.

III. To examine the nature of topics discussed by the specialist palliative care team and the oncology team and compare the amount of clinic time (both absolute and proportion) spent on each supportive/palliative care issue.

IV. To compare the number of empathic statements between the specialist palliative care team and the oncology team.

V. To compare the processes of supportive/palliative care delivery between patients seeing the oncology team without specialist palliative care (Cohort A) and patients seeing the oncology team when specialist palliative care team is involved (Cohort B).

OUTLINE:

Patients complete questionnaires over 15-20 minutes and undergo audio recording of clinic conversations between the oncology team or the specialist palliative care team. Patients' medical records are also reviewed.

Enrollment

200 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Within 6 months of diagnosis of metastatic (or stage IV) solid malignancies
Age 18 or greater
English speaking
Follow-up clinic visit (Supportive Care and Medical Oncology Outpatient Clinics at MD Anderson Cancer Center)
Medical oncologist listed as the attending physician
COHORT A (Oncology team only cohort): Patients should not have been referred to palliative care services at MD Anderson Cancer Center
COHORT B (Oncology team and specialist palliative care cohort): Patients should have an upcoming specialist palliative care follow-up visit within 1 week of a medical oncology visit

Exclusion criteria

Delirium (Memorial Delirium Assessment Scale [MDAS] >= 13/30)
Significant hearing impairment requiring multiple repetitions during the screening process (that may prolong clinic time)