Ride to Care - Quality of Life With Transportation for RT

University of California, San Francisco

Overview

This trial studies how well Uber health intervention works in eliminating transportation barriers for disadvantaged patients with cancer that has spread to nearby tissue, lymph nodes, or other places in the body, undergoing ambulatory palliative radiotherapy. Uber health intervention provides free transportation to disadvantaged patients and may reduce the amount of missed radiotherapy appointments, patient anxiety, and the amount of unplanned emergency department visits, as well as improve quality of life.

PRIMARY OBJECTIVES: I. To test whether eliminating transportation barriers for disadvantaged cancer patients can reduce the 6-month rate of unplanned emergency department (ED) visits. SECONDARY OBJECTIVES: I. To test whether eliminating transportation barriers for disadvantaged cancer patients for the duration of a palliative radiotherapy course will improve prescribed treatment completion rates and reduce treatment delays and overall time to treatment completion. II. To test whether eliminating transportation barriers for disadvantaged cancer patients for the duration of a palliative radiotherapy course will have an impact on physician choice for therapeutic modality, \[3-dimensional conformal radiation therapy (3D CRT) versus intensity-modulated radiation therapy (IMRT) versus stereotactic body radiation therapy (SBRT)\] and the fractionation schedules to minimize patient inconvenience. III. To test whether eliminating transportation barriers for disadvantaged cancer patients for the duration of a palliative radiotherapy course can reduce the short-term (6- months) rate of grade \>= 3 radiation related adverse events as measured by the Common Terminology Criteria for Adverse Events (CTCAE) version 5. IV. To test whether eliminating transportation barriers for disadvantaged cancer patients for the duration of a palliative radiotherapy course can improve the patient?s experience, functional outcome, and overall quality of life as measured by the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)30. V. To test whether eliminating transportation barriers for disadvantaged cancer patients for the duration of a palliative radiotherapy course can reduce re-treatment rates, improve the progression free survival rates, and overall survival. VI. To determine if living within San Francisco County versus the surrounding counties (Alameda, Contra Costa, Marin, San Mateo) within the San Francisco Bay Area has an impact on outcomes. OUTLINE: Patients receive Uber rides to and from scheduled radiotherapy appointments for up to 6 months. After completion of study, patients are followed up every 3 months for up to 3 years.

Study Type

INTERVENTIONAL

Allocation

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Conditions

Locally Advanced Malignant Neoplasm Metastatic Malignant Neoplasm

Interventions

Quality-of-Life AssessmentOTHER

Ancillary studies

Questionnaire AdministrationOTHER

Ancillary studies

Supportive CarePROCEDURE

Receive Uber rides

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Written informed consent (and assent when applicable) obtained from patient or patients's legal representative and ability for patient to comply with the requirements of the study * Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 * Histologically confirmed locally advanced or metastatic cancer * Patients who have received prior courses of radiotherapy are eligible * If patient answers yes to \>= 1/4 of the questions below: * In the last six months, have you ever delayed seeing a doctor or getting care? * Do you anticipate having a hard time coming to University of California, San Francisco (UCSF) for radiation therapy due to transportation challenges? * Does lack of money for transportation expenses (parking, taxi, bus) make it difficult for you to get care quickly for medical problems? * Does arranging for transportation (driving yourself, getting neighbor or family to drive you) for your cancer treatments make you anxious or worried?" Exclusion Criteria: * Pregnant, breastfeeding, or unwilling to practice birth control during participation in the study * Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data * Patients who are living at a facility such as a nursing home or skilled nursing facility * Patients who do not live within a 30-mile radius of one of the radiation oncology sites at University of California San Francisco (UCSF) * Patients who are currently receiving or expected to be receive UCSF affiliated transportation services prior to enrollment onto the study

Outcomes

Primary Outcomes

Rate of unplanned emergency department (ED) visits

For each enrolled patient, any unplanned ED visit over the six months from consultation/enrollment will be documented as an event.

Time frame: Up to 6 months

Rate of unplanned hospital admissions

For each enrolled patient, any unplanned hospital admission the six months from consultation/enrollment will be documented as an event.

Time frame: Up to 6 months

Secondary Outcomes

Change in mean pain score on the European Organization for Research and Treatment of Cancer quality of life questionnaire 30 (EORTC-QLQ-C30)

The Pain score consists of responses to two items with responses ranging from 1="Not at all" to 4="Very Much". The raw score is calculated by estimating the mean of the two items that make up the pain scale with a resulting total range of 1-4. These scores are then transformed to standardized scale score, so that scores range from 0 to 100. A high score for the pain scale / item represents a high level of symptomatology / problems.

Time frame: Up to 3 years

Change in mean overall global health status score on the EORTC-QLQ-C30

The global health status score consists of responses to two items with responses ranging from 1="very poor" to 4="excellent". The raw score is calculated by estimating the mean of the two items that make up the global health scale with a resulting total range of 1-7. These scores are then transformed to standardized scale score, so that scores range from 0 to 100. A high score for the global health status represents a higher quality of life.

Time frame: Up to 3 years

Change in functional domain scores on the EORTC-QLQ-C30

The functional domains measure the quality of life in Physical functioning, Role functioning, Emotional functioning, Cognitive functioning, Social functioning. Scores consists of responses to items with responses ranging from 1="Not at all" to 4="Very Much". The raw score is calculated by estimating the mean of the items that make up each domains with a resulting total range of 1 - 4. These scores are then transformed to standardized scale score, so that scores range from 0 to 100. A high score for the functional domains represents a high level of functioning

Data from ClinicalTrials.gov

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