Shared Care: Patient-Centered Management After Hematopoietic Cell Transplantation

Dana-Farber Cancer Institute

Status: Completed

Conditions: Other Cancer

Treatments: Other: Standard Care; Other: Shared Care

Study type: Interventional

Funder types: Other

Identifiers

NCT03244826

17-253

Details and patient eligibility

About

This research study aims to evaluate the effectiveness of allowing patients who have had a hematopoietic cell transplant to receive some of their post-transplant care with a local oncologist rather than returning to the transplant center for all of their follow-up.

Full description

Hematopoietic Cell Transplantation (HCT) - also known as bone marrow transplant - is only available at select centers in the United States which can collect and store stem cells, as well as care for patients before their new immune system cells take hold. For this reason, many patients who undergo HCT live at great distances from their HCT center. Also, after hospital discharge, the first 180 days post-HCT are very important, as patients must be managed closely with frequent follow-up visits.

A potential way to make life easier for HCT patients is to allow some of the post-transplant care to be provided by local oncologists who practice closer to where patients live. This could reduce the burden on patients and their caregivers; however, it is not known if a shared care model would ultimately benefit them. The investigators want to assess the effectiveness of a Shared Care program which allows patients to receive half of their post-HCT care at the HCT center, and the other half with their local oncologist

Enrollment: 404 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age >= 18 years of age
• Scheduled to receive an allogeneic HCT at the Dana-Farber Inpatient Hospital or BWH under the care of a DFCI physician
• Residence in New York, Maine, New Hampshire, Vermont, Connecticut, or Massachusetts
• Referred from or live less than 1 hour from one of the local participating centers.
• Ability to read English (to fill out standard QOL forms)

Exclusion criteria

• Age <18 years of age
• Scheduled to receive an autologous HCT
• Has received an allogeneic transplant in the past; scheduled to receive a second allogeneic transplant
• Did not receive an allogeneic HCT at Dana-Farber
• Does not live in New York, Maine, New Hampshire, Vermont, Connecticut, or Massachusetts

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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404 participants in 3 patient groups

Shared Care

Experimental group

Description:

* For the first 90 days, patients alternate between local oncologist and DFCI for weekly visits. * From 90 to 180 days, patients alternate between local and DFCI every 2-3 weeks. * Shared Care include the following * Formal Care Coordination Plan * Patient Engagement and Education * Local Oncologist Engagement and Education * Patient/Local Oncologist/Transplant Oncologist Web Portal

Treatment:

Other: Shared Care

Usual Care

Other group

Description:

* Patients receive all follow-up care at DFCI only, which is currently the Standard Care. * Majority of routine visits in first 180 days will be at DFCI.

Treatment:

Other: Standard Care

Non-Randomized

Other group

Description:

Patients receive all follow-up care at DFCI only (Standard Care).

Treatment:

Other: Standard Care