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Sponsors and Collaborators: |
Vanderbilt-Ingram Cancer Center National Cancer Institute (NCI) |
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Information provided by: | National Cancer Institute (NCI) |
ClinicalTrials.gov Identifier: | NCT00666211 |
RATIONALE: An Opioid Titration Order Sheet that allows healthcare providers to adjust the dose and schedule of pain medication may help improve pain treatment for patients with cancer. It is not yet known whether the use of an Opioid Titration Order Sheet is more effective than standard care in treating pain caused by cancer.
PURPOSE: This randomized phase III trial is studying an Opioid Titration Order Sheet to see how well it works compared with standard care in treating patients with cancer pain.
Condition | Intervention | Phase |
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Chronic Myeloproliferative Disorders Leukemia Lymphoma Lymphoproliferative Disorder Multiple Myeloma and Plasma Cell Neoplasm Myelodysplastic Syndromes Myelodysplastic/Myeloproliferative Diseases Pain Precancerous/Nonmalignant Condition Unspecified Adult Solid Tumor, Protocol Specific |
Other: educational intervention Other: medical chart review Other: questionnaire administration Procedure: pain therapy Procedure: quality-of-life assessment |
Phase III |
Study Type: | Interventional |
Study Design: | Supportive Care, Randomized |
Official Title: | Phase III Randomized Trial of an Opioid Titration Order Sheet Compared to Standard of Care in Patients With Cancer Related Pain. |
Estimated Enrollment: | 128 |
Study Start Date: | May 2005 |
Estimated Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
OBJECTIVES:
OUTLINE: This is a multicenter study. Participating centers are randomized to 1 of 2 treatment arms.
The program consists of standard written materials about communicating pain to providers, opioids and side effect management, as well as a tailored discussion about patient concerns and specific information about prescribed opioid medications. Patients are also instructed in the use of the daily pain diary. Patients are then discharged from the clinic with instructions to contact the treating physician (through standard procedures) for problems with pain or side effects. The study staff conducts weekly telephone interviews to prevent changes in patient pain management practice. The treating physician continues to manage pain in their usual manner.
Patients' pain is managed on study for 8 weeks in the absence of unacceptable toxicity, pain crisis, or new site of pain.
Patients complete a demographic questionnaire at baseline and other questionnaires at 2, 4, and 6 weeks (over the telephone) and at 8 weeks (at site or by telephone), including the Functional Assessment Screening Questionnaire (FASQ), the Brief Pain Inventory-Interference (PPI-I), The Profile of Mood States-Short Form (POMS-SF), and the Quality of life (FACT-G) questionnaire. Patients also complete a pain diary recording daily measures of pain dimensions, analgesic use (i.e., fixed dose opioids, rescue doses, and non-opioids), adjuvant medications, and side effects that prevented the patient from taking medications. Data in the pain diary is transcribed over the telephone on a weekly basis.
Clinical data, including the type of cancer, stage of disease, time since diagnosis, current treatment for cancer, type of pain, time since onset of pain, and time of first opioid prescription, as well as information regarding analgesics (opioid and non-opioid), adjuvant medications, and medications to manage side effects prescribed during the study is collected from patients' medical records. Anticancer and palliative treatment received during the study is monitored via treating physician records.
The physician charts are reviewed after study completion to determine whether pain, treatment, and response are adequately documented and treated. The documentation in the physician charts is compared to the documentation obtained by the study staff during the study.
Ages Eligible for Study: | 21 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Cancer-related pain requiring fixed-dose opioid therapy
Has received ≥ 1 week of fixed-dose opioid therapy AND meets any of the following criteria:
PATIENT CHARACTERISTICS:
PRIOR CONCURRENT THERAPY:
United States, Kentucky | |
Mitchell Memorial Cancer Center at Owensboro Medical Health System | Recruiting |
Owensboro, Kentucky, United States, 42303 | |
Contact: Contact Person 270-688-3600 | |
United States, Tennessee | |
Erlanger Cancer Center at Erlanger Hospital - Baroness | Recruiting |
Chattanooga, Tennessee, United States, 37403 | |
Contact: Clinical Trials Office - Erlanger Cancer Center 423-778-6947 | |
MBCCOP - Meharry Medical College - Nashville | Recruiting |
Nashville, Tennessee, United States, 37208 | |
Contact: Contact Person 615-327-6000 | |
Veterans Affairs Medical Center - Nashville | Recruiting |
Nashville, Tennessee, United States, 37212 | |
Contact: Clinical Trials Office - Veterans Affairs Medical Center - Nas 615-327-4751 | |
Vanderbilt-Ingram Cancer Center at Franklin | Recruiting |
Nashville, Tennessee, United States, 37064 | |
Contact: Nancy Wells 615-322-6184 | |
Vanderbilt-Ingram Cancer Center | Recruiting |
Nashville, Tennessee, United States, 37232-6838 | |
Contact: Clinical Trials Office - Vanderbilt-Ingram Cancer Center 800-811-8480 | |
Vanderbilt-Ingram Cancer Center - Cool Springs | Recruiting |
Nashville, Tennessee, United States, 37064 | |
Contact: Nancy Wells 615-322-6184 |
Principal Investigator: | Nancy Wells, DNSc, RN | Vanderbilt-Ingram Cancer Center |
Investigator: | Mary Dietrich | Vanderbilt-Ingram Cancer Center |
Investigator: | Tony Hudson | Vanderbilt-Ingram Cancer Center |
Investigator: | Patty Hendricks | Vanderbilt-Ingram Cancer Center |
Investigator: | Hannah Spahr | Vanderbilt-Ingram Cancer Center |
Responsible Party: | Vanderbilt-Ingram Cancer Center ( Nancy Wells ) |
Study ID Numbers: | CDR0000594527, VU-VICC-SUPP-0424, VU-VICC-040410 |
Study First Received: | April 23, 2008 |
Last Updated: | February 27, 2009 |
ClinicalTrials.gov Identifier: | NCT00666211 History of Changes |
Health Authority: | Unspecified |
pain unspecified adult solid tumor, protocol specific accelerated phase chronic myelogenous leukemia acute undifferentiated leukemia adult acute lymphoblastic leukemia in remission adult acute myeloid leukemia in remission adult acute myeloid leukemia with 11q23 (MLL) abnormalities adult acute myeloid leukemia with inv(16)(p13;q22) adult acute myeloid leukemia with t(15;17)(q22;q12) adult acute myeloid leukemia with t(16;16)(p13;q22) adult acute myeloid leukemia with t(8;21)(q22;q22) atypical chronic myeloid leukemia blastic phase chronic myelogenous leukemia chronic myelomonocytic leukemia chronic phase chronic myelogenous leukemia |
mast cell leukemia meningeal chronic myelogenous leukemia progressive hairy cell leukemia, initial treatment prolymphocytic leukemia recurrent adult acute lymphoblastic leukemia recurrent adult acute myeloid leukemia recurrent adult T-cell leukemia/lymphoma refractory chronic lymphocytic leukemia refractory hairy cell leukemia relapsing chronic myelogenous leukemia secondary acute myeloid leukemia stage I adult T-cell leukemia/lymphoma stage I chronic lymphocytic leukemia stage II adult T-cell leukemia/lymphoma stage II chronic lymphocytic leukemia |
Polycythemia Chronic Myelomonocytic Leukemia Blast Crisis Large Granular Lymphocyte Leukemia Lymphoma, Mantle-Cell Mantle Cell Lymphoma Follicular Lymphoma Mycoses Acute Myelocytic Leukemia Preleukemia Hemorrhagic Disorders Leukemia, Prolymphocytic Acute Myeloid Leukemia, Adult Leukemia, Lymphocytic, Chronic, B-Cell Neoplasm Metastasis |
Lymphoma, Large-Cell, Anaplastic Thrombocythemia, Hemorrhagic Hodgkin Disease Myelodysplastic Myeloproliferative Disease Lymphoma, Large B-Cell, Diffuse Immunoproliferative Disorders Precursor Cell Lymphoblastic Leukemia-Lymphoma Hematologic Diseases Blood Coagulation Disorders Leukemia, Myelomonocytic, Chronic Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative Leukemia, Mast-Cell Hairy Cell Leukemia Myeloproliferative Disorders Leukemia, Myeloid |
Precancerous Conditions Blood Protein Disorders Paraproteinemias Hemostatic Disorders Leukemia Preleukemia Hemorrhagic Disorders Pathologic Processes Syndrome Lymphoma, Large-Cell, Immunoblastic Cardiovascular Diseases Lymphoma Disease Neoplasms by Histologic Type |
Immunoproliferative Disorders Immune System Diseases Hematologic Diseases Myelodysplastic Syndromes Myeloproliferative Disorders Vascular Diseases Multiple Myeloma Lymphatic Diseases Neoplasms Bone Marrow Diseases Lymphoproliferative Disorders Lymphoma, Non-Hodgkin Myelodysplastic-Myeloproliferative Diseases Neoplasms, Plasma Cell |