MedTrace Logo

Predictive Analytics and Behavioral Nudges to Improve Palliative Care in Advanced Cancer

NCT05590962 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 562

Last updated 2025-02-06

Study results available
· View outcomes & findings →

Summary

Patients with advanced cancer suffer from high symptom burden and aggressive end-of-life care. Early specialty palliative care is an evidence-based practice that improves symptom burden, quality of life, and survival in advanced cancer. However, over half of patients with advanced cancer die before receiving palliative care. Clinician-level biases and suboptimal identification of high-risk patients are major barriers to palliative care uptake. In this 2-arm pragmatic clinical trial, the investigators will randomize practices within a large community oncology network to receive an intervention consisting of algorithm-based default palliative care referrals. The investigators will study the impact of such an intervention on palliative care utilization and end-of-life outcomes.

Conditions

Interventions

OTHER

EHR Nudge

Clinicians in Arm 1 (intervention) will receive a EHR notification with option to opt-out for palliative care referral for any eligible high-risk patient, defined by a risk score ≥1 for Stage IV cancer patients and ≥2 for Stage III cancer patients. If the risk score is above 8, they will be scheduled within 2 weeks, and all other patients will be scheduled within 4 weeks. Clinician will have the option to opt-out for any patient by responding to the notification which will be sent to the research coordinator. If the clinician does not respond, the research coordinator will approach patient via telephone, explain the rationale for referral based on a predetermined script, and offer and schedule an outpatient or telemedicine palliative care consultation per patient preference. Follow-up visits will occur at the discretion of the palliative care clinician, usually monthly.

Sponsors & Collaborators

  • Tennessee Oncology

    collaborator OTHER

  • Emerson Collective

    collaborator UNKNOWN

  • Abramson Cancer Center at Penn Medicine

    lead OTHER

Principal Investigators

  • Ravi Parikh · Penn/ACC

  • Sandhya Mudumbi · TennOnc

Study Design

Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Model
PARALLEL

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2022-11-09
Primary Completion
2023-06-13
Completion
2023-10-03

Countries

  • United States

Study Locations

More Related Trials

Entities

Diseases

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT05590962 on ClinicalTrials.gov