Effect of Early Palliative Care on Quality of Life of Patients With Advanced Cancer: a Randomised Controlled Trial.

NCT01865396 | Completed

• 1 other identifier: 2012/865
• Study Type: interventional
• Target: 268
• Locations: 1 country
• Sites: 1

Brief Summary

The World Health Organization (WHO) defines palliative care as an approach to improve the quality of life of patients and their families facing life-threatening illness, through prevention and relief of pain and of physical, psychosocial and spiritual problems. The WHO stresses that palliative care is applicable early in the course of the illness together with other therapies that are intended to cure or prolong life, such as chemotherapy or radiation therapy. For the benefit of the patient, palliative care is however often given (too) late in the course of the disease of incurably ill patients. The aim of our study is to measure the effect of interventional palliative care on quality of life, mood and end-of-life care of patients with advanced cancer and their families. These patients have a limited life expectancy and a high symptom burden, this leads us to suggest that these patients may be benefited with palliative care soon after diagnosis of metastatic disease (interventional palliative care). The research design of this study is a randomized controlled trial with, on the one hand, an intervention group in which patients and their families receive interventional palliative care in combination with standard cancer care and on the other hand a control group in which patients and their families receive only standard oncologic care. Participants in the intervention group will meet the palliative support team shortly after diagnosis. Afterwards, the palliative support will meet them at least once a month. This intervention focuses on topics such illness understanding, symptom management, decision making and coping with the disease. Participants in the control group will only meet with the palliative support team at the patient's own request or after referral by the oncologist or the nursing staff.

Conditions

Life-limiting Cancer With Prognosis of Approximately 1 Year

Outcome Measures

Primary Outcomes (3)

• Quality of life of the patient and his family caregiver at baseline.

  This will be measured with validated questionnaires(EORTC-QLQ C30, McGill QoL, SF-36).

  at baseline

• Quality of life of the patient and his family caregiver at 12 weeks.

  This will be measured with validated questionnaires (EORTC-QLQ C30, McGill QoL, SF-36).

  at 12 weeks

• Quality of life of the patient and his family caregiver, 6-weekly after 12 weeks.

  This will be measured with validated questionnaires (EORTC-QLQ C30, McGill QoL, SF-36).

  6-weekly after 12 weeks

Secondary Outcomes (4)

• Influence of palliative care on mood and illness-understanding of patients and family caregivers at baseline.

  at baseline.

• Influence of palliative care on mood and illness-understanding of patients and family caregivers at 12 weeks.

  at 12 weeks

• Influence of palliative care on mood and illness-understanding of patients and family caregivers 6-weekly, after 12 weeks.

  6-weekly, after 12 weeks.

• Influence of palliative care on the decision of physicians with regards to end-of-life-care.

  after death of patient

Study Arms (2)

early palliative care

EXPERIMENTAL

Interventional palliative care, after diagnosis and once a month.

Behavioral: Interventional palliative care

Standard care

ACTIVE COMPARATOR

Patients will receive the standard oncologic care.

Behavioral: Standard oncologic care

Interventions

Interventional palliative care BEHAVIORAL

Palliative support team will meet the patient soon after diagnosis of incurable disease and will meet the patient at least once a month. The patient will also receive the standard oncologic care.

early palliative care

Standard oncologic care BEHAVIORAL

Patients will receive standard oncologic care.

Standard care

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with life-limiting cancer (prognosis of approximately 1 year) are eligible if:
• Patients are within 12 weeks of referral from an other hospital after receiving first line treatment or within 8 to 12 weeks of a new diagnosis (histological and cytological confirmed):
• Metastatic and advanced pancreatic, stomach, oesophageal and biliary tract adenocarcinoma;
• Metastatic or advanced NSCLC (stage IIIB or IV) or metastatic SCLC,
• Malignant pleural mesothelioma
• Metastatic or advanced head and neck cancer (stage III or IV)
• Patients are within 12 weeks of progression after receiving treatment and have an prognosis of approximately 1 year:
• Metastatic and locally advanced colorectal cancer, with progression after second line treatment
• Metastatic or advanced prostate carcinoma, after second line treatment
• Advanced breast cancer with visceral and/or brain metastasis, with progression on second or third line treatment
• Metastatic melanoma,
• Metastatic or advanced kidney cancer,
• Metastatic or advanced bladder cancer after first line treatment,
• An Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 and ability to read and respond to questions in Dutch.

You may not qualify if:

• Patients under 18 years old
• Patients with impaired cognition

Sponsors & Collaborators

• University Ghent: lead
• Vrije Universiteit Brussel: collaborator
• Fund for Scientific Research, Flanders, Belgium: collaborator

Study Sites (1)

Ghent University Hospital

Ghent, 9000, Belgium

Location

Related Publications (2)

• Vanbutsele G, Pardon K, Van Belle S, Surmont V, De Laat M, Colman R, Eecloo K, Cocquyt V, Geboes K, Deliens L. Effect of early and systematic integration of palliative care in patients with advanced cancer: a randomised controlled trial. Lancet Oncol. 2018 Mar;19(3):394-404. doi: 10.1016/S1470-2045(18)30060-3. Epub 2018 Feb 3.

  PMID: 29402701 DERIVED

• Vanbutsele G, Van Belle S, De Laat M, Surmont V, Geboes K, Eecloo K, Pardon K, Deliens L. The systematic early integration of palliative care into multidisciplinary oncology care in the hospital setting (IPAC), a randomized controlled trial: the study protocol. BMC Health Serv Res. 2015 Dec 15;15:554. doi: 10.1186/s12913-015-1207-3.

  PMID: 26666301 DERIVED

Study Officials

• Simon Vanbelle, MD, PhD

  University Hospital, Ghent

  STUDY DIRECTOR

• Luc Deliens, PhD, MD

  Vrije Universiteit Brussel and Ghent University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 24, 2013
• First Posted: May 30, 2013
• Study Start: April 1, 2013
• Primary Completion: April 1, 2017
• Study Completion: April 1, 2017
• Last Updated: December 1, 2021

Record last verified: 2021-11

Locations

BE (1)