Randomized Study of Individualized Care Plans for Hematopoietic Cell Transplant Survivors

Center for International Blood and Marrow Transplant Research (CIBMTR)

Status: Completed

Conditions: Adult Hematopoietic Cell Transplant (HCT) Survivors 1-2 Yrs Post Most Recent HCT

Treatments: Other: Individualized Survivorship Care Plan (SCP)

Study type: Interventional

Funder types: Other; NETWORK

Identifiers

NCT02200133

13-SCP

Details and patient eligibility

About

This randomized study will compare a personalized Survivorship Care Plan (SCP) template with usual care (no SCP). The investigators hypothesize that the personalized SCP that incorporates patient specific treatment exposures and provides a framework for long term followup based on those exposures and subsequent risks for late complications will enhance patient survivorship confidence in knowledge, increase adherence to recommended healthcare, improve health behaviors and reduce HCT-related emotional distress.

Full description

This randomized study will compare a personalized Survivorship Care Plan (SCP) template with usual care (no SCP). The investigators hypothesize that the personalized SCP that incorporates patient specific treatment exposures and provides a framework for long term followup based on those exposures and subsequent risks for late complications will enhance patient survivorship confidence in knowledge, increase adherence to recommended healthcare, improve health behaviors and reduce hematopoietic cell transplant (HCT) - related emotional distress.

The randomized study design will be able to evaluate the efficacy of individualized SCP in enhancing transplant survivor knowledge, health behaviors and health care utilization for recommended preventive care. Most transplant centers do not use a standardized SCP for their HCT recipients, and hence, the control arm would represent prevalent standard of care (e.g., discharge summary, provider-to-provider communication).

Transplant centers that will participate in this study will represent a spectrum of center types (e.g., geographic location, center volume, resources and infrastructure) and patient populations (e.g., healthcare disparities, urban/rural population, distance from transplant center). Usual care for each center will be documented at the time of determining center eligibility. The study principal investigators, in consultation with the protocol team, will make the determination about center eligibility after reviewing the centers "usual care" procedures. In order to avoid contamination of the study intervention, centers will be asked not to change their follow-up practices for the period they are enrolling patients on the study.

The primary objective of the investigators study is to evaluate the impact of an individualized SCP on survivor knowledge about past diagnostic and treatment details, confidence in knowledge about prevention and treatment of late-effects, access to resources and familial risk of cancer. For this objective, the investigators will compare the change in score on the Confidence in Survivorship Information instrument from baseline to 6 months after the study intervention.

Secondary objectives will investigate the influence of individualized SCP on standardized measures of HCT related distress, knowledge of recommended care, health behaviors, self-efficacy, and health care utilization.

Enrollment: 495 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult (≥ 18 years at time of allogeneic HCT recipient at participating transplant centers)
• Survival 1-2 years after most recent HCT with no evidence of relapse, disease progression, or secondary cancer on last follow-up
• All diagnoses will be eligible
• All transplant types will be eligible (autologous or allogeneic related or unrelated)
• All graft sources will be eligible (bone marrow, peripheral blood or umbilical cord blood)
• All conditioning regimens will be eligible (in case of allogeneic HCT, patient could have received myeloablative or non-myeloablative/reduced-intensity conditioning)
• Patient may have received more than one HCT
• Patient must be proficient in English (written and spoken) to complete study assessments
• Patient must have a valid mailing address within the United States to receive study materials
• Signed informed consent form from patient

Exclusion criteria

• Patients who have received their transplant at a different transplant center will not be eligible for the study

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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495 participants in 2 patient groups

Individualized Survivorship Care Plan (SCP)

Experimental group

Description:

* Participant information sheet and instructions on how to use the SCP * Patient version of individualized SCP that includes but is not limited to: (1) a treatment summary that consists of disease characteristics and treatment details (including HCT), and (2) recommendations for preventive care and screening for late complications based on patient treatment exposures (age, type of transplant, use of TBI, corticosteroid exposure as part of HCT, and history of GVHD) * Newest Vital Sign nutrition label to measure health literacy and its instructions * Participants may receive other materials their transplant center routinely provides to patients for follow-up care (e.g., discharge summary or clinic note)

Treatment:

Other: Individualized Survivorship Care Plan (SCP)

Usual care (no SCP)

No Intervention group

Description:

* Materials that their transplant center routinely provides to patients for follow-up care * Newest Vital Sign nutrition label to measure health literacy and its instructions * Participants randomized to the usual care arm who complete the 6 month study assessments will receive their individualized SCP upon completion of the patient's participation. Participants who withdraw from the study or who do not complete the 6 month assessment will not receive the individualized SCP.