Clinical and Cost-effectiveness of a Comprehensive geriatric assessment and management for Canadian elders with Cancer-the 5C study: a study protocol for a randomised controlled phase III trial.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
10 05 2019
Historique:
entrez: 13 5 2019
pubmed: 13 5 2019
medline: 22 4 2020
Statut: epublish

Résumé

Geriatric assessment and management is recommended for older adults with cancer referred for chemotherapy but no randomised controlled trial has been completed of this intervention in the oncology setting. A two-group parallel single blind multi-centre randomised trial with a companion trial-based economic evaluation from both payer and societal perspectives with process evaluation. A total of 350 participants aged 70+, diagnosed with a solid tumour, lymphoma or myeloma, referred for first/second line chemotherapy, who speak English/French, have an Eastern Collaborative Oncology Group Performance Status 0-2 will be recruited. All participants will be followed for 12 months. Geriatric assessment and management for 6 months. The control group will receive usual oncologic care. All participants will receive a monthly healthy ageing booklet for 6 months. To study the clinical and cost-effectiveness of geriatric assessment and management in optimising outcomes compared with usual oncology care. Participants will be allocated to one of the two arms in a 1:1 ratio. The randomisation will be stratified by centre and treatment intent (palliative vs other). Quality of life. (1) Cost-effectiveness, (2) functional status, (3) number of geriatric issues successfully addressed, (4) grades3-5 treatment toxicity, (5) healthcare use, (6) satisfaction, (7) cancer treatment plan modification and (8) overall survival. For the primary outcome we will use a pattern mixture model using an intent-to-treat approach (at 3, 6 and12 months). We will conduct a cost-utility analysis alongside this clinical trial. For secondary outcomes 2-4, we will use a variety of methods. Our study has been approved by all required REBs. We will disseminate our findings to stakeholders locally, nationally and internationally and by publishing the findings. NCT03154671.

Identifiants

pubmed: 31079079
pii: bmjopen-2018-024485
doi: 10.1136/bmjopen-2018-024485
pmc: PMC6530407
doi:

Substances chimiques

Antineoplastic Agents 0

Banques de données

ClinicalTrials.gov
['NCT03154671']

Types de publication

Clinical Trial Protocol Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e024485

Informations de copyright

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Martine T E Puts (MTE)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

Tina Hsu (T)

Division of Medical Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada.

Caroline Mariano (C)

Department of Medical Oncology, The Royal Columbian Hospital, New Westminster, British Columbia, Canada.

Johanne Monette (J)

Division of Geriatric Medicine, The Jewish General Hospital, Montreal, Quebec, Canada.

Sarah Brennenstuhl (S)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

Eric Pitters (E)

Older adult representative, Oshawa, Ontario, Canada.

Jack Ray (J)

Older adult representative, Calgary, Alberta.

Doreen Wan-Chow-Wah (D)

Division of Geriatric Medicine, The Jewish General Hospital, Montreal, Quebec, Canada.

Natascha Kozlowski (N)

Department of Medical Oncology, R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health, Oshawa, Ontario, Canada.

Monika Krzyzanowska (M)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Eitan Amir (E)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Department of Medical Oncology, Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada.

Christine Elser (C)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Department of Medical Oncology, Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada.

Raymond Jang (R)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Anca Prica (A)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Murray Krahn (M)

Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.

Francois Beland (F)

Public Health School, University of Montreal, Montreal, Quebec, Canada.

Simon Bergman (S)

Department of Surgery, Jewish General Hospital, Montreal, Quebec, Canada.

Rama Koneru (R)

Department of Medical Oncology, R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health, Oshawa, Ontario, Canada.

Manon Lemonde (M)

Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada.

Ewa Szumacher (E)

Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Joan Zidulka (J)

Department of Oncology, St. Mary's Hospital, Montreal, Quebec, Canada.

Shek Fung (S)

Department of Oncology, St. Mary's Hospital, Montreal, Quebec, Canada.

Anson Li (A)

Department of Geriatric Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada.

Urban Emmenegger (U)

Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Rajin Mehta (R)

Division of Geriatric Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Kendra Flemming (K)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

Henriette Breunis (H)

Department of Medicine, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Shabbir M H Alibhai (SMH)

Department of Medicine and Institute of Health Policy, Management, and Evaluation, University Health Network and University of Toronto, Toronto, Ontario, Canada.

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