Inpatient Palliative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation

Mass General Brigham

Status: Completed

Conditions: Stem Cell Transplant

Treatments: Other: Standard Transplant Care; Other: Palliative Care Intervention

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03641378

18-261

R01CA222014 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This research study is evaluating the impact of early involvement of a palliative care team working with the transplant oncology team will have on the quality of life, symptoms, and mood of patients undergoing stem cell transplantation.

Full description

The Participant has a type of blood cancer and will be undergoing stem cell transplantation. Frequently people undergoing stem cell transplantation experience physical and emotional symptoms during the course of their hospitalization for stem cell transplantation. These can be very distressing to both patient and the family members. The study doctors want to know if the early introduction of a team of clinicians that specialize in the lessening (palliation) of many of these distressing symptoms may improve the participant overall care.

This team of clinicians is called the palliative care team and they focus on ways to improve the participant pain and other symptom management (nausea, fatigue, shortness of breath, anxiety, etc.) and to assist the participant and the participant's family in coping with the emotional and social issues associated with your diagnosis. The team consists of physicians and advance practice nurses who have been specially trained in the care of patients facing serious illness.

The main purpose of this study is to compare two types of care - standard transplant oncology care and standard transplant oncology care with early involvement of palliative care clinicians to see which is better for improving the experience of patients and families with blood cancers undergoing stem cell transplantation.

The purpose of this research study is to find out whether introducing patients and families undergoing stem cell transplantation to the palliative care team that specializes in symptom management can improve the physical and psychological symptoms that patients and families experience during hospitalization for stem cell transplantation.

The study will use a series of questionnaires to measure the participant and the participant 's caregivers' quality of life, physical symptoms, and mood. Study questionnaires will be completed in the hospital or clinic with assistance provided as need.

Enrollment: 546 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Patient Inclusion Criteria

• adult patients (≥ 18 years) with hematologic malignancy admitted for autologous or allogeneic HCT.
• ability to read and respond to questions in English or Spanish or to complete questionnaires with assistance from an interpreter.

Caregiver Eligibility Criteria:

• adult (≥ 18 years) relative or a friend of a patient who agrees to participate in the study whom the patient identified as living with them or having in-person contact with him or her at least twice per week.
• ability to read and respond to questions in English or Spanish or to complete questionnaires with the assistance of an interpreter.

Exclusion criteria

Patient Exclusion Criteria

• Patients undergoing HCT for benign hematologic conditions
• Patients undergoing outpatient HCT.
• Patients with psychiatric or cognitive conditions which the treating clinicians believes prohibits compliance with study procedures

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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546 participants in 2 patient groups

Inpatient Palliative Care Intervention

Experimental group

Description:

* Patients and Caregivers will complete baseline self-report assessments at the time of obtaining informed consent * Palliative Care Intervention * Therapeutic Relationship --Develop a strong therapeutic relationship with patients and caregivers * Assessment and Treatment of Patient Symptoms --Clarify the symptoms the patient will likely experience and offer reassurance about the methods for reporting and treating symptoms * Managing Patients and Caregivers Expectations --Address early on patients and caregivers' concerns about the trajectory of illness during HCT and treatment side effects * Coping with Illness and HCT --Introduce strategies to help improve adjustment (e.g., behavioral, cognitive, and spiritual approaches; accepting illness while maintaining hope; social support)

Treatment:

Other: Palliative Care Intervention

Transplant Care Alone

Experimental group

Description:

* Patients and Caregivers will complete baseline self-report assessments at the time of obtaining informed consent. * Standard Transplant Care

Treatment:

Other: Standard Transplant Care