RECRUITING

Veteran-Centered Care for Advanced Liver Disease (Vet-CALD)

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

Advanced liver disease is a serious illness that disproportionately affects Veterans, many of whom hope for curative liver transplantation. However, too few receive a transplant and most continue to suffer from increasing symptoms and hospitalizations. The proposed project uses a whole person, Veteran-centered approach that identifies Veterans with advanced liver disease using a population-based health management system and integrates curative and early supportive care using a telemedicine-based nurse care counselor to (1) discuss patient's understanding of illness severity and prognosis, (2) identify priorities and care preferences and (3) align curative and supportive care options to achieve patient priorities. Study outcomes include changes in (1) rates of consideration for liver transplantation, and (2) completion of serious illness discussions. Findings will inform adaptations to the intervention and facilitators for its dissemination.

Official Title

Integrating Veteran-Centered Care for Advanced Liver Disease (I-VCALD)

Quick Facts

Study Start:2024-10-01
Study Completion:2027-09-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT06068491

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 80 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Patients will be between 18 and 80 years of age
  2. * Patients must be Veterans
  3. * Patients must have been in care at one of the recruiting sites for 1 year with two or more encounters in primary care
  4. * Patients must have AdvLD, defined based on two ambulatory or one inpatient encounter ICD-10 codes for new onset cirrhosis complications or MELD-Na \>15 in the previous 12 months
  1. * Non-Veteran patients
  2. * Patients who do not speak English, do not have access to a telephone or computers, or who are unable to complete a valid informed consent form after three attempts
  3. * Patients who have already made significant progress toward our endpoints: a) with prior history of liver transplantation, or b) on the liver transplant waiting list, or c) had formal evaluation for liver transplantation in the past 3 years
  4. * Patients with very limited life expectancy (advanced cancer, acute-on-chronic liver failure, and hospice patients)
  5. * Patients hospitalized, or in long term facilities or nursing homes at the time they meet inclusion criteria
  6. * Patients with chart diagnosis of uncontrolled mental health or schizophrenia

Contacts and Locations

Study Contact

Donna L Smith, MEd
CONTACT
(713) 440-4423
Donna.Smithd19d7@va.gov
Fasiha Kanwal, MD MSHS
CONTACT
(713) 440-4495
Fasiha.Kanwal@va.gov

Principal Investigator

Fasiha Kanwal, MD MSHS
PRINCIPAL_INVESTIGATOR
Michael E. DeBakey VA Medical Center, Houston, TX

Study Locations (Sites)

Central Arkansas Veterans Healthcare System , Little Rock, AR
Little Rock, Arkansas, 77205
United States
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, California, 94304-1207
United States
VA Greater Los Angeles Healthcare System, West Los Angeles, CA
West Los Angeles, California, 90073-1003
United States
Michael E. DeBakey VA Medical Center, Houston, TX
Houston, Texas, 77030-4211
United States

Collaborators and Investigators

Sponsor: VA Office of Research and Development

  • Fasiha Kanwal, MD MSHS, PRINCIPAL_INVESTIGATOR, Michael E. DeBakey VA Medical Center, Houston, TX

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 Date2024-10-01
Study Completion Date2027-09-30

Study Record Updates

Study Start Date2024-10-01
Study Completion Date2027-09-30

Terms related to this study

Keywords Provided by Researchers

  • Patient-Centered Care
  • Randomized Controlled Trial
  • Delivery of Healthcare, Integrated

Additional Relevant MeSH Terms

  • Liver Diseases