COMPLETED

Introducing Palliative Care (PC) Within the Treatment of End Stage Liver Disease (ESLD)

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This is a comparative effectiveness study of two pragmatic models aiming to introduce palliative care for end stage liver disease patients. The 2 comparators are: Model 1: Consultative Palliative Care (i.e. direct access to Palliative Care provider), Model 2: Trained Hepatologist- led PC intervention (i.e. a hepatologist will receive formal training to deliver Palliative Care services) Primary Outcome: The change in quality of life from baseline to 3 months post enrollment as assessed by FACT-Hep (Functional Assessment of Cancer Therapy- Hepatobiliary). Primary Hypothesis: Compared to consultative PC, the trained hepatologist-led PC for ESLD patients will show superior primary outcome. In the event of nonsignificant superiority, the trained hepatologist-led PC led will show non-inferiority (NI) by ruling out a 4-point reduction (NI margin) in mean of the primary outcome as compared to the consultative PC. Power: The study has 83.2% power to detect minimal clinically important difference (MCID) of 9 points in mean of the primary outcome between the two randomized arms. We have 79.2% power for the noninferiority hypothesis, under assumption that the trained hepatologist-led PC arm performs better than the consultative PC arm by half of the above MCID. Setting: 19 Clinical Centers across US are recruited to participate in this study. Qualitative nested study will interview patients, caregivers and providers to assess their experiences with participating in the palliative care trial.

Official Title

Introducing Palliative Care (PC) Within the Treatment of End Stage Liver Disease (ESLD): A Cluster Randomized Controlled Trial

Quick Facts

Study Start:2019-01-30
Study Completion:2025-08-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:COMPLETED

Study ID

NCT03540771

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years to 120 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. cirrhosis and a decompensation event indicative of ESLD (such as ascites, variceal bleeding or hepatic encephalopathy) within the prior 6 months, or
  2. 2. hepatocellular cancer (HCC) except Barcelona Stage D, or multifocal HCC (as defined by standard guidelines and confirmed by treating hepatologist).
  1. Pregnancy or breastfeeding
  2. Severe psychiatric disorders
  3. Active substance abuse
  4. Unstable medical conditions
  5. Inability to comply with study requirements

Contacts and Locations

Principal Investigator

Manisha Verma, MD, MPH
PRINCIPAL_INVESTIGATOR
Albert Einstein Healthcare Network
Victor Navarro, MD
PRINCIPAL_INVESTIGATOR
Albert Einstein Healthcare Network

Study Locations (Sites)

University of Alabama
Birmingham, Alabama, 35233
United States
Banner Health- University Medical Center
Phoenix, Arizona, 85006
United States
UCSF Fresno
Fresno, California, 93701
United States
Loma Linda Unversity Health
Loma Linda, California, 92354
United States
VA West Haven
West Haven, Connecticut, 06516
United States
University of Florida
Gainesville, Florida, 32611
United States
Miami VA Medical Center
Miami, Florida, 33125
United States
Indiana University
Indianapolis, Indiana, 46202
United States
VA Boston
Boston, Massachusetts, 02130
United States
University of Michigan Medical Center
Ann Arbor, Michigan, 48109
United States
Kansas City VA Medical Center
Kansas City, Missouri, 64128
United States
VA New York Harbor
Brooklyn, New York, 11209
United States
VA Bronx
The Bronx, New York, 10468
United States
UNC Liver Center
Chapel Hill, North Carolina, 27599
United States
Durham V.A. Medical Center
Durham, North Carolina, 27705
United States
Corporal Michael J. Crescenz VA Medical Center
Philadelphia, Pennsylvania, 19104
United States
Albert Einstein Medical Center
Philadelphia, Pennsylvania, 19141
United States
Medical University of South Carolina
Charleston, South Carolina, 29425
United States
Baylor College of Medicine
Houston, Texas, 77030
United States

Collaborators and Investigators

Sponsor: Albert Einstein Healthcare Network

  • Manisha Verma, MD, MPH, PRINCIPAL_INVESTIGATOR, Albert Einstein Healthcare Network
  • Victor Navarro, MD, PRINCIPAL_INVESTIGATOR, Albert Einstein Healthcare Network

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2019-01-30
Study Completion Date2025-08-30

Study Record Updates

Study Start Date2019-01-30
Study Completion Date2025-08-30

Terms related to this study

Keywords Provided by Researchers

  • palliative care
  • hepatology
  • decompensated cirrhosis

Additional Relevant MeSH Terms

  • End Stage Liver Disease
  • Decompensated Cirrhosis of Liver