Early integrated telehealth versus in-person palliative care for patients with advanced lung cancer: A study protocol

Isaac S. Chua, Finly Zachariah, William Dale, Josephine Feliciano, Laura Hanson, Leslie Blackhall, Tammie Quest, Kimberly Curseen, Carl Grey, Ramona L Rhodes, Laura Shoemaker, Maria Silveira, Stacy Fischer, Sean O'Mahony, Kostantinos Leventakos, Chardria Trotter, Isabella Sereno, Mihir Kamdar, Jennifer Temel, Joseph A. Greer

Research output: Contribution to journalArticle

Abstract

Introduction: Early palliative care (PC) integrated with oncology care improves quality of life (QOL), depression symptoms, illness understanding, and end-of-life (EOL) care for patients with advanced lung cancer. The aims of this trial are to compare the effect of delivering early integrated PC through telehealth versus in-person on patient and caregiver outcomes. We hypothesize that both modalities for delivering early PC would be equivalent for improving patient QOL, communication about EOL care preferences with their oncologist, and length of stay in hospice. Methods: For this comparative effectiveness trial, we will enroll and randomize 1250 adult patients with advanced nonsmall cell lung cancer (NSCLC), who are not being treated with curative intent, to receive either early integrated telehealth or in-person PC at 20 cancer centers throughout the United States. Patients may also invite a family caregiver to participate in the study. Patients and their caregivers in both study groups meet at least every four weeks with a PC clinician from within 12 weeks of patient diagnosis of advanced NSCLC until death. Participants complete measures of QOL, mood, and quality of communication with oncologists at baseline before randomization and at 12, 24, 36, and 48 weeks. Information on health care utilization, including length of stay in hospice, will be collected from patients' health records. To test equivalence in outcomes between study groups, we will compute analysis of covariance and mixed linear models, controlling for baseline scores and study site. Study Implementation and Stakeholder Engagement: To ensure that this comparative effectiveness trial and findings are as patient centered and meaningful as possible, we have incorporated a robust patient and stakeholder engagement plan. Our stakeholder partners include (1) patients/families, (2) PC clinicians, (3) telehealth experts and clinician users, (4) representatives from health care systems and medical insurance providers, and (5) health care policy makers and advocates. These stakeholders will inform and provide feedback about every phase of study implementation.

Original languageEnglish (US)
Pages (from-to)S7-S19
JournalJournal of Palliative Medicine
Volume22
Issue numberS1
DOIs
StatePublished - Sep 1 2019

Fingerprint

Telemedicine
Palliative Care
Lung Neoplasms
Quality of Life
Caregivers
Hospices
Terminal Care
Non-Small Cell Lung Carcinoma
Length of Stay
Communication
Patient Acceptance of Health Care
Patient Participation
Random Allocation
Health Policy
Insurance
Administrative Personnel
Linear Models
Outcome Assessment (Health Care)
Depression
Delivery of Health Care

Keywords

  • early palliative care
  • lung cancer
  • telehealth

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine

Cite this

Chua, I. S., Zachariah, F., Dale, W., Feliciano, J., Hanson, L., Blackhall, L., ... Greer, J. A. (2019). Early integrated telehealth versus in-person palliative care for patients with advanced lung cancer: A study protocol. Journal of Palliative Medicine, 22(S1), S7-S19. https://doi.org/10.1089/jpm.2019.0210

Early integrated telehealth versus in-person palliative care for patients with advanced lung cancer : A study protocol. / Chua, Isaac S.; Zachariah, Finly; Dale, William; Feliciano, Josephine; Hanson, Laura; Blackhall, Leslie; Quest, Tammie; Curseen, Kimberly; Grey, Carl; Rhodes, Ramona L; Shoemaker, Laura; Silveira, Maria; Fischer, Stacy; O'Mahony, Sean; Leventakos, Kostantinos; Trotter, Chardria; Sereno, Isabella; Kamdar, Mihir; Temel, Jennifer; Greer, Joseph A.

In: Journal of Palliative Medicine, Vol. 22, No. S1, 01.09.2019, p. S7-S19.

Research output: Contribution to journalArticle

Chua, IS, Zachariah, F, Dale, W, Feliciano, J, Hanson, L, Blackhall, L, Quest, T, Curseen, K, Grey, C, Rhodes, RL, Shoemaker, L, Silveira, M, Fischer, S, O'Mahony, S, Leventakos, K, Trotter, C, Sereno, I, Kamdar, M, Temel, J & Greer, JA 2019, 'Early integrated telehealth versus in-person palliative care for patients with advanced lung cancer: A study protocol', Journal of Palliative Medicine, vol. 22, no. S1, pp. S7-S19. https://doi.org/10.1089/jpm.2019.0210
Chua, Isaac S. ; Zachariah, Finly ; Dale, William ; Feliciano, Josephine ; Hanson, Laura ; Blackhall, Leslie ; Quest, Tammie ; Curseen, Kimberly ; Grey, Carl ; Rhodes, Ramona L ; Shoemaker, Laura ; Silveira, Maria ; Fischer, Stacy ; O'Mahony, Sean ; Leventakos, Kostantinos ; Trotter, Chardria ; Sereno, Isabella ; Kamdar, Mihir ; Temel, Jennifer ; Greer, Joseph A. / Early integrated telehealth versus in-person palliative care for patients with advanced lung cancer : A study protocol. In: Journal of Palliative Medicine. 2019 ; Vol. 22, No. S1. pp. S7-S19.
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