This study explores whether supportive care interventions that might reduce rehospitalization could be implemented and feasible, in subjects within a high-risk group of subjects with newly diagnosed hospitalized advanced lung cancer (ALC). This study screened 50 subjects from health records and consented to 15 of these screened subjects. These 15 subjects responded to PRO questionnaires.
Subjects will be considered high risk if they have small cell histology, longer than 8 days hospitalization, high comorbidity, emergency department use or hospitalization in the previous 6 months, prescription of a wheelchair on hospital discharge, or Black and/or Hispanic race. Supportive care interventions such as navigation and palliative care will be recommended for this group. All hospitalized subjects with newly diagnosed ALC will be offered web- or telephone-based patient-reported outcome (PRO) symptom monitoring for 90 days following hospital discharge if they provide consent. Medical record evaluation of consented subjects will provide data for risk assessment and the high-risk group definition. Healthcare utilization including emergency department visits, hospitalizations, outpatient palliative care, and cancer treatment received will be compared.
Study Type
OBSERVATIONAL
Enrollment
18
UNC Lineberger
Chapel Hill, North Carolina, United States
Success of the risk-based stratification system implementation - contacted
The success of the risk-based stratification system implementation- contacted will be determined by the ratio of subjects who were contacted to the whole group is equal to or higher than 70%, in the high-risk group.
Time frame: Up to 5 days
Success of the risk-based stratification system implementation - referred
The success of the risk-based stratification system implementation- referred will be determined by the ratio of subjects who were referred to the whole group is equal to or higher than 70%, in the high-risk group.
Time frame: Up to 5 days
Success of the risk-based stratification system implementation - navigation
The success of the risk-based stratification system implementation- navigation will be determined by the ratio of subjects who received guidance to the whole group is equal to or higher than 70%, in the high-risk group.
Time frame: Up to 16 days
Success of the risk-based stratification system implementation - palliative care
The success of the risk-based stratification system implementation - palliative care will be determined by the ratio of subjects who received palliative care to the whole group is equal to or higher than 70%, in the high-risk group.
Time frame: Up to 16 days
Time to receipt of outpatient palliative care
The time to receipt of outpatient palliative care will be defined as the time between the date of palliative care and hospital discharge based on the high-risk and low-risk groups.
Time frame: Up to 90 days
Acceptability of the supportive care intervention
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Acceptability of the supportive care intervention will be assessed by the percentage of subjects who attend supportive care consultations as determined through electronic health records ( EHR) review.
Time frame: Up to 180 days
Acceptability of the risk stratification system the time to complete for providers
Acceptability of the risk stratification system time to complete for providers will be assessed by the time to complete risk stratification per subject.
Time frame: Up to 90 days
Acceptability of the risk stratification system time to complete thoracic oncology clinical team
Acceptability of the risk stratification system time to complete the thoracic oncology clinical team will be assessed by the perceived usefulness to the thoracic oncology clinical team
Time frame: Up to 90 days
Implementation of PRO-based symptom monitoring
Implementation of patient reported outcomes (PRO)-based symptom monitoring will be determined by the percentage of eligible subjects who complete weekly PROs and the percentage of concerning symptoms reported to the clinical team of more than 70.
Time frame: Up to 90 days
Implementation of PRO-based symptom monitoring reported to clinical team
Implementation of PRO-based symptom monitoring will be determined by the percentage of concerning symptoms reported to the clinical team.
Time frame: Up to 90 days
Acceptability of PRO-based symptom monitoring subject
Acceptability of PRO-based symptom monitoring to subjects will be measured by the percentage of eligible subjects who agree to participate in the patient-reported outcome report (PRO) system (success: \>66%).
Time frame: Up to 90 days
Acceptability of PRO-based symptom monitoring to the clinical team
Acceptability of PRO-based symptom monitoring to the clinical team will be determined by the percentage of concerning symptoms resulting in action by any member of the clinical team.(success: \>75% reporting somewhat useful, useful, or very useful).
Time frame: Up to 90 days
Acceptability of PRO-based symptom monitoring to the thoracic oncology clinical team
Acceptability of PRO-based symptom monitoring to the clinical team will be determined by the percentage of concerning symptoms perceived usefulness to the thoracic oncology clinical team (success: \>75% reporting somewhat useful, useful, or very useful).
Time frame: Up to 90 days