Chemotherapeutic Toxicity, Metastatic Solid Tumor, Oncology
Conditions
Brief summary
This study will formally test the quality improvement intervention of an EMR based tool that informs medical oncologists visiting a patient for the first time of potential risk of chemotherapy toxicity.
Interventions
OTHERChemotherapy toxicity tool
CARG is an EMR based tool that informs medical oncologists visiting a patient for the first time of potential risk of chemotherapy toxicity. This intervention will make available a simple calculator which includes: Gender, Height and weight, Cancer Subtype, Hemoglobin, How is your hearing (with hearing aid, if needed)?, Number of falls in the past 6 months, Can you take your own medicines, Does your health limit you in walking one block., During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)? and Glomerular filtration rate. The CARG chemotoxicity calculator will be built into the patient navigator and its use will be assessed on a monthly basis and used to inform iteration.
OTHEROncology Consultation
Oncologists will consult new patient with a new diagnosis of cancer.
Sponsors
Masonic Cancer Center, University of Minnesota
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Intervention model description
Providers, who were selected based on having at least 20 new patients with metastatic solid tumors in a 6-month period in 2021, will be randomized in a 1:1 ratio, stratified by quartiles of patient volume.
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* New outpatient visits with a medical oncologist following a new diagnosis of cancer and no prior history of chemotherapy treatment. * aged \> 65 will be included.
Exclusion criteria
* Patients who opt out of clinical research will be excluded from analysis, but not the intervention (which will be applied to all patients). Specifically, as sometimes opt-in/opt out status is coded ambiguously in the data we will only analyze results of patients with clear opt in and no history of opt out. * Patients with no EHR data after initial oncologist appointment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Unplanned hospitalization rate | Within 3 months of the Index Visit with the oncologist | Measured at the patient level as a binary outcome (yes/no) based on date of initial visit with the oncologist. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Healthcare contact days | Within 3 and 6 months of the Index Visit with the oncologist | Measured at the patient level as a continuous outcome (number of days). |
| Chemotherapy use rate | Within 3 months of the Index Visit with the oncologist | Measured at the patient level as a binary outcome (yes/no) if patient ever received systemic cancer-directed treatment. |
| Chemotherapy modification rate | Within 3 months of the Index Visit with the oncologist | Measured at the patient level as a binary outcome (yes/no) if patient had dose, schedule, or number of chemotherapy changed. |
| Palliative Care Referral | Within 6 months of the Index Visit with the oncologist | Measured at the patient level as a binary outcome (yes/no) based on presence of a scheduled palliative care appointment |
| Chemotherapy toxicity tool use rate | Within 3 months of the Index Visit with the oncologist | Measured at the patient level as a binary outcome (yes/no) based on whether the oncologist used the tool for that patient. |
Countries
United States
Outcome results
None listed