Chronic Myelogenous Leukemia - Chronic Phase
Conditions
Keywords
Advanced Practice Nursing, Quality of life, Adverse event
Brief summary
Chronic Myeloid Leukemia (CML) affects 820 people per year in France (2018), half of them are older than 60 years old. Tyrosine Kinase Inhibitors (TKI) are new kind of targeted therapy whose efficiency allow for a high rate of complete molecular response, leading to a disruption of treatment under certain conditions. Optimizing CML treatment is a major concern, particularly for adverse events management, treatment compliance and therapeutic response. Multiple studies demonstrated that grade ≤ II adverse events are most likely to be under reported by patients and clinicians. Although these adverse events are mostly reported by clinical examination, needing minimal treatment. These toxicities could alter daily and domestic living activities, potentially impacting treatment compliance and therapeutic response. Therefore, early detection of these adverse events is a major challenge for the prognosis and care of CML. The Advanced Practice Nurse (APN), a new health care professional, acquired the skills needed to independently follow, manage and care the patients with medical approvals. At international level, many studies, in oncology and in others domains, have been done to demonstrate the added value of the APN, particularly in improving patient's quality of life, management, care of drug-induced adverse events and treatment compliance. In France, because of the recentness of the profession, only few studies were have been conducted. The goal of this study is to demonstrate the benefit of APN in clinical follow-up, quality of life, treatment compliance, and therapeutic response of CML patients. These effects could be managed thanks to early detection and management of ≤ grade II adverse events during consultation, in partnership with the patients, and in collaborative working.
Interventions
OTHERAPN and medical management
Patients are followed by the advanced practice nurse and the hematologist.
OTHERMedical management
Patients are followed by the hematologist only (standard of care).
BEHAVIORALQuality of life assessment
EORTC-QLQ-C30 questionnaire
BEHAVIORALTreatment compliance assessment
GIRERD questionnaire
Sponsors
Centre Hospitalier Henri Duffaut - Avignon
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
60 patients will be included, these patients will be randomized into two groups.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years old. * CML patient in chronic phase, eligible for oral therapy. * Newly diagnosed CML and/or initiating oral therapy : * Patient changing treatment for non-response or loss of therapeutic response or toxicities, on the condition that these toxicities are resolved or grade I maximum at the time of inclusion. * Newly start of oral therapy. * Patient eligible to a follow-up by an advanced practice nurse. * Patient capable to understand french and complete a questionnaire.
Exclusion criteria
* Patient that had a follow-up \> 3 months by an advanced practice nurse for CML before inclusion. * Patient changing treatment for toxicities, if these toxicities are still \> grade I at inclusion. * Patient enrolled in another interventional research protocol for CML. * Pregnant women. * Patient under legal protection, deprived of liberty or unable to be included in a research protocol.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the role of the advanced practice nurse in early detection of grade I-II adverse events during care and management of Chronic Myeloid Leukemia compared to standard of care (hematologist only). | Inclusion and 6 months | Grade I-II adverse events rate |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the role of the advanced practice nurse in early detection of grade I-II adverse events during care and management of Chronic Myeloid Leukemia compared to standard of care (hematologist only). | 6 months and 12 months | Grade I-II adverse events rate |
| Assessment of patient's quality of life | Inclusion, 6 months and 12 months | European Organization for Research and Treatment of Cancer Quality-of-Life-Questionnaire-Core-30 : EORTC-QLQ-C30 (composed of both multi-item scales and single-item measures : 5 functional scales, 3 symptom scales, 6 single items and a global health status. All of the the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. ie : A high score for a functional scale represents a high level of functioning, a high score for the global health status represents a high quality of life but a high score for a symptom scale or a single item represents a high level of symptomatology). |
| Assessment of patient's compliance to treatment | 6 months and 12 months | GIRERD questionnaire (measures range from 0 to 6. A low score represents a high level of compliance). |
| Grade > II adverse events rates | 6 months and 12 months | — |
| Hospitalization rate | 6 months and 12 months | — |
| Treatment discontinuation rate and/or treatment change rate | Every medical consultation, from inclusion to 12 months | — |
| Consultation time comparison between advanced practice nurse and hematologist | Every medical consultation, from inclusion to 12 months | — |
| Molecular response rate assessment | 6 months and 12 months | — |
Countries
France
Contacts
CONTACTMarilyne Grinand, PhD
CONTACTChristine Tosello, APN
PRINCIPAL_INVESTIGATORChristine Tosello, APN
Centre Hospitalier d'Avignon, Service d'Oncologie Médicale-Hématologie Clinique
Outcome results
None listed