Hospital at Home at EOL in Heme Malignancies

Massachusetts General Hospital72 enrolled

Overview

This study is evaluating an intervention, which the investigators call "Optimize End of Life (EOL) Care at Home," that entails remote patient monitoring and home-based supportive care for patients with advanced hematologic malignancies.

This research study is a single arm pilot feasibility study, which is the first-time investigators are examining this care at home intervention in patients with advanced hematologic malignancies. The research study procedures include screening for eligibility, questionnaires, remote patient monitoring (e.g. patient-reported symptoms, home monitored vital signs) and hospital care at home (e.g. providing maximal supportive care to to address and manage patients' symptoms) and structured communications oncology clinicians to optimize end of life care for patients with advanced hematologic malignancies. Participants will include 3 groups: 1\) Enrolled patients with advanced hematologic malignancies receiving the end of life (EOL) care at home intervention; 2) caregivers of these patients; and 3) oncology clinicians caring for these patients. Participants will be in this research study for approximately six months after consent. It is expected that about 30 patients, 30 caregivers, and 15 oncology clinicians will take part in this research study. Medically Home company is supporting this research study by providing funding.

Study Type

INTERVENTIONAL

Allocation

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

Conditions

Hematologic Malignancy

Interventions

End of Life (EOL) Care at at HomeOTHER

Remote monitoring and home-based care designed for patients with advanced hematologic malignancies

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age 18 or older * diagnosed with relapsed or refractory hematologic malignancy * must be receiving treatment with non-curative intent or supportive care alone based on the intent of chemotherapy as reported in order entry or Electronic Health Record * deemed eligible to receive EOL care at home based on the primary oncologist's assessment * Able to communicate and respond to questionnaires in English or with the assistance of an interpreter. * residing within 50 miles of MGH. Of note, patients requiring supportive transfusions in the oncology clinic will still be eligible to participate. Exclusion Criteria: * Those with uncontrolled psychiatric illness or impaired cognition interfering with their ability to understand study procedures and provide written informed consent as determined by the primary oncologist.

Locations (1)

Massachusetts General Hospital Cancer Center

Boston, Massachusetts, United States

Outcomes

Primary Outcomes

Enrollment Rate

The primary endpoint is feasibility. The proposed intervention will be deemed feasible if at least 60% (95% confidence interval +/- 18%) of eligible patients are enrolled in the study.

Time frame: 6 months

Retention Rate

The primary endpoint is feasibility. The proposed intervention will be deemed feasible if at least 80% of enrolled participants will complete a minimum of 60% of their daily assessments (i.e. patient-reported symptoms)

Time frame: 6 months

Secondary Outcomes

Acceptability of the intervention

Qualitative acceptability ratings from patients, caregivers, and oncology clinicians defined by perceptions of usefulness, effectiveness, and relevance of the intervention obtained via interviews regarding acceptability from patients, family caregivers, and oncology clinicians.

Time frame: 6 months

Patient Quality of Life (Functional Assessment of Cancer Therapy-General - Fact-G)

Change in quality of life as measured by the FACT-G throughout the study. FACT-G score ranges from 0 to 108 points with higher score indicating better quality of life

Time frame: up to 6 months

Caregiver Quality of Life (CareGiver Oncology QOL)

Change in caregiver quality of life as measured by the CarGOQOL throughout the study. Caregiver Oncology QOL questionnaire ranges from 0 to 100 points with higher scores indicating better caregiver quality of life

Time frame: 6 months

Patient Symptom Burden (using the Edmonton Symptom Assessment Scale-revise)

Change in patient symptom burden measured with Edmonton Symptom Assessment System-revised (ESAS-r). Scores range from 0-100 with higher scores indicate worse symptom burden.

Data from ClinicalTrials.gov

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