Implementing Palliative Care: Learning Collaborative vs. Technical Assistance
This trial studies the delivery of the ENABLE palliative care program by two different methods called a Virtual Learning Collaborative or Technical Assistance for patients with advanced cancer and their caregivers. Palliative care is specialized medical care for people with a serious illness that occurs at the same time as other medical treatment. The purpose of palliative care is to provide relief from symptoms and stress of serious illness, to help patients and their families clarify goals of care, and to focus on social support and spiritual well-being. The focus of the ENABLE palliative care program is on living well, managing stress, patient communication of their personal values and hopes for care, social support, and symptom management. This study may help doctors find the best ways to include palliative care services into their practices and the impact of palliative care on cancer patients and their caregivers? quality of life.
Key Inclusion Criteria
For a patient to be eligible for participation in this study, all of the following criteria must apply.
- NCORP PRACTICE: All participating practice clusters will be required to identify two (or more) ENABLE nurse coaches as part of study eligibility to deliver the ENABLE program. For practices that only have 1 nurse available, we will allow only 1 ENABLE nurse coach.
- NCORP PRACTICE: Commitment of the ENABLE nurse coach(es) to be trained to conduct the palliative care assessment and sessions.
- NCORP PRACTICE: Desire to implement ENABLE, including presence of an investigator (e.g., primary affiliate principal investigator [PI], oncology physician, Cancer Care Delivery Research [CCDR] Lead) and/or program administrator/supervisor who are willing to be key contacts.
- NCORP PRACTICE: Demonstrated support/buy-in from oncology physicians who are willing to enroll patients.
- NCORP PRACTICE: Agreement of practice leadership and staff to support/participate in the study activities.
- NCORP practice: If necessary, willingness to participate in a phone interview to determine capacity to implement the ENABLE program.
- NCORP PRACTICE STAFF: The ENABLE implementation team at each participating practice will include at minimum the ENABLE nurse coach(es) and a coordinator. Other members of the team can include the primary affiliate PI, an oncology physician or investigator, CCDR lead (if different than the coordinator, and/or the program administrator/supervisor).
- ONCOLOGY PHYSICIAN: Eligible providers at NCORP practices are oncology physicians (i.e., medical oncologists or radiation oncologists) caring for oncology patients. We do not require that all physicians at a practice setting agree to participate. Oncology physicians must work at an NCORP practice cluster with no plans to leave that NCORP practice or retire at the time of enrollment into the study.
- ENABLE NURSE COACH: NCORP practices will identify an advanced practice provider (including a nurse practitioner or physician assistant) or nurse with experience in oncology or palliative care to serve as the ENABLE nurse coach.
- ENABLE NURSE COACH: All ENABLE nurse coaches will be licensed and have a minimum of two years of experience caring for patients with cancer in either an oncology or palliative care setting.
- ENABLE NURSE COACH: All ENABLE nurse coaches are required to complete training by the study team in conducting the palliative care assessment and the ENABLE sessions.
- PATIENTS: English-speaking as not all patient measures have been validated in other languages.
- PATIENTS: Willing to complete palliative care assessment and ENABLE sessions.
- PATIENTS: Diagnosed within the last 90 days with an advanced cancer (defined as a newly diagnosed stage III/IV, recurrence, or progressive solid tumor cancer).
- PATIENTS: Expected survival of at least 6 months.
- PATIENTS: Have access to telephone that can receive calls.
- PATIENTS: Able to provide informed consent.
- CAREGIVERS: English-speaking as not all caregiver measures have been validated in other languages.
- CAREGIVERS: Willing to complete the ENABLE sessions.
- CAREGIVERS: Selected by the patient when asked if there is a ?unpaid relative or friend who knows them well and who provides regular support to their cancer.?
- CAREGIVERS: Have access to telephone that can receive calls.
- CAREGIVERS: Able to provide informed consent.
Key Exclusion Criteria
A patient will not be eligible if any of the following criteria applies
- PATIENTS: Received previous palliative care services.
To learn more, visit ClinicalTrials.Gov
Gary Morrow, University of Rochester NCORP Research Base