Cancer, Dementia
Conditions
Brief summary
Building upon prior work, the investigator team developed a communication intervention for older adults with ADRD who are considering a decision about cancer management (adapted intervention: COACH-Cog). The investigators hypothesize that for patients with dual diagnoses of ADRD and cancer, COACH-Cog will increase autonomy support of care partners and patients in the decision-making process, leading to greater acknowledgement and support of cognitive concerns and cognitive-related goals, thereby improving goal concordant care. The investigators are conducting a pilot randomized controlled trial (RCT; cluster randomized by physician) including approximately 45 oncology clinicians and 130 patient/care partner dyads evaluating the effect of COACH-Cog on care partner and patient autonomy support, care partner well-being, goal-concordance, and communication.
Interventions
BEHAVIORALCOACH-Cog
Oncology clinician intervention components: 1) a brief training video (completed once during the duration of the study following enrollment and randomization), 2) For each patient/care partner dyad that is subsequently enrolled onto the study that the clinician cares for, the oncology clinician will receive the results of the patient's GA with targeted management recommendations for identified GA domain impairments Patient/Care partner dyad intervention components: 1) Care partners (and patients if able) will participate in a one-time communication coaching session; 2) Patient GA results with management recommendations to consider discussing with the oncology team will be provided to care partners and patients.
Sponsors
University of Rochester
National Institute on Aging (NIA)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Investigator, Outcomes Assessor)
Intervention model description
Cluster-randomized
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
PATIENTS: Patient Inclusion Criteria: 1. Be age 65 or older 2. Have a clinical diagnosis of Alzheimer's disease or related dementia (ADRD \[Alzheimer's disease, vascular dementia, Lewy body dementia, frontotemporal dementia, or dementia of unknown subtype\]) 3. Have a clinical diagnosis of cancer (any type or stage) 4. Anticipate a potential decision about cancer-related management, as confirmed by the patient's primary medical oncology clinician. 5. Have a care partner willing and able to participate in the study 6. Are able to read and understand English. The communication coaching session will be delivered in English, thus necessitating this requirement. 7. Be able to provide informed consent (as measured by UBACC) or have a Legally Authorized Representative to provide informed consent Patient
Exclusion criteria
Patient
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Care Partner: Health Care Climate Questionnaire (HCCQ) | 4-weeks post oncology clinical encounter | Care Partner autonomy support; score range: 6-42; higher score is better. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Zarit Caregiver Burden Assessment | 4-weeks post-oncology clinical encounter and 3-months post-oncology clinical encounter | 4-Item Measure Care partner well-being: Caregiver burden; total score range 0-16; Higher score is worse burden. |
| Horton QOL S-subscale | 4-weeks post-oncology clinical encounter and 3-months post-oncology clinical encounter | 11-Item Measure (Subscale Measure) of Care partner well-being: Quality of Life; Total score range 0-11; higher score is worse quality of life. |
| Care Partner PROMIS Depression | 4-weeks post-oncology clinical encounter and 3-months post-oncology clinical encounter | Care partner well-being: Depression; score range 4-20; higher score is worse |
| Care partner PROMIS Anxiety | 4-weeks post-oncology clinical encounter and 3-months post-oncology clinical encounter | Care partner well-being: Anxiety; score range 4-20; higher score is worse |
| Care partner: Patient-Centered Communication in Cancer Care (PCC-Ca) | 4-weeks post-oncology clinical encounter and 3-months post-oncology clinical encounter | Care partner communication; score range 1-5; higher scores are better |
| Care partner: Health Care Climate Questionnaire - Age (HCCQ-Age) | 4-weeks post-oncology clinical encounter and 3-months post-oncology clinical encounter | Care partner Age-related autonomy support; score range 0-28; higher scores are worse |
| Care partner: Qualitative assessment of goal concordance | 3-months post-oncology clinical encounter | Care partner: Goal concordance; qualitative analysis if goal concordance occurred (yes/no); range 0-130; higher number better |
| Care partner: Decision Regret Scale | 3-months post-oncology clinical encounter | Care partner: Decision regret; score range 5-25; higher score is worse |
Countries
United States
Contacts
CONTACTAllison Magnuson
CONTACTJessica Bauer
PRINCIPAL_INVESTIGATORAllison Magnuson
University of Rochester
Outcome results
None listed