My Team of Care: a Pilot Randomized Controlled Trial of an Online Communication Tool for Collaborative Care

Mount Sinai Hospital, Canada49 enrolled

Overview

This project will pilot and test a new online communication tool, Loop, developed within a research framework with participatory and user-centred design. This pilot trial focuses on advanced cancer as an example of complex care. Cancer care involves many healthcare providers, spanning hospital to home. There is no organized way for them to communicate. Loop is a practical tool for ongoing collaboration in the patient's actual team of care that engages patients. The study will answer the questions: does Loop improve communication efficiency, engage patients and family physicians, and show early benefits in quality and health care costs?

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Neoplasms Communication

Interventions

Loop is a secure online communication system centered on the patient that assembles the patient's actual healthcare team for ongoing collaborative care. The patient and caregiver are integral members of the team. Loop is cross-organizational, cross-setting and interprofessional. It is for ongoing, interactive, contextual, team-based communication. Loop is explicitly for asynchronous communication, not instant messaging. The stream of messages is stored and can be sorted for ease of viewing. The tool was developed with user-centred design and requires no prior training.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients with Stage IV cancer, or Patients with stage III cancer and poor prognosis as determined by a physician (\>3 months but \<2 years) 2. Eastern Cooperative Oncology Group (ECOG) performance status score ≤2 3. Each patient must have at least two healthcare providers, including an attending oncologist or palliative care physician 4. Patient and, if applicable, family caregiver must be ≥18 years of age 5. Literacy and language capacity and competency to provide informed consent 6. Patient or caregiver must have access to a computer and the internet Exclusion Criteria: 1. Patients without the capacity to participate in use of the online tool, and do not have a caregiver who can engage in use of the tool on their behalf 2. Participants without the capacity to participate in evaluation of outcome measures, including, but not limited to, online and paper-based multiple-choice questions, checklists, and visual analogue scales, and do not have a family caregiver who can complete outcome measures 3. A potential candidate for or currently receiving hormone therapy for breast or prostate cancer 4. Patients with a prognosis of \<3 months as determined by attending physician 5. Patients with impaired mental status as previously assessed by a physician or judged by research staff using the Bedside Confusion Scale 6. It has been determined that the patient is participating in another study precluding them from taking part in this study, as determined by an agreed-upon algorithm, tracked and managed by study coordinators

Locations (2)

Princess Margaret Cancer Center

Toronto, Ontario, Canada

Mount Sinai Hospital

Toronto, Ontario, Canada

Outcomes

Primary Outcomes

Trial feasibility measured with number of patients recruited for study who have consented and participate for the duration of the study.

Time frame: 1 year

Secondary Outcomes

Trial feasibility measured with number of healthcare providers recruited for study who have consented and participate for the duration of the study.

Time frame: 1 year

Trial feasibility measured with number of family caregivers recruited for study who have consented and participate for the duration of the study.

Time frame: 1 year

Palliative Care Outcomes Scale

A 12 item questionnaire measuring patient-reported quality of care

Time frame: 3 months

Picker Ambulatory Cancer Care Survey Continuity and Coordination subscale

An 8 item questionnaire measuring patient-perceived continuity and coordination of care

Time frame: 3 months

Ambulatory and Home Care Record

Measure of ambulatory, home-based and acute care health services utilization, and associated public and private costs

Time frame: 3 months

Edmonton Symptom Assessment Scale

A 10 item questionnaire measuring symptom intensity

Time frame: 3 months

Eastern Cooperative Oncology Group score

A measure of performance status

Time frame: 3 months

The proportion of eligible participants who are invited to participate

Time frame: 1 year

The proportion of invited participants who consent to participate

Time frame: 1 year

The mean duration of participation of all study participants

Time frame: 1 year

Instrument completion rate for the Palliative Care Outcomes Scale

Time frame: 1 year

Item response rate for the Palliative Care Outcomes Scale

Time frame: 1 year

Instrument completion rate for the Picker Ambulatory Cancer Care Survey Continuity and Coordination subscale

Time frame: 1 year

Item response rate for the Picker Ambulatory Cancer Care Survey Continuity and Coordination subscale

Time frame: 1 year

Instrument completion rate for the Ambulatory and Home Care Record

Time frame: 1 year

Item response rate for the Ambulatory and Home Care Record

Time frame: 1 year

Instrument completion rate for the Edmonton Symptom Assessment Scale

Time frame: 1 year

Item response rate for the Edmonton Symptom Assessment Scale

Time frame: 1 year

Number of family physicians who participate per study group

Time frame: 1 year