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Trial registered on ANZCTR
Registration number
ACTRN12623000770662
Ethics application status
Approved
Date submitted
16/06/2023
Date registered
14/07/2023
Date last updated
14/07/2023
Date data sharing statement initially provided
14/07/2023
Type of registration
Retrospectively registered
Titles & IDs
Public title
Mixed methods evaluation of the feasibility, acceptability and adherence of prehabilitation for head and neck cancer patients undergoing radiotherapy.
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Scientific title
Mixed methods evaluation of the feasibility, acceptability and adherence of prehabilitation for head and neck cancer patients undergoing radiotherapy.
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Secondary ID [1]
309607
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Head and neck cancer
329919
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Mental health
329920
0
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Malnutrition
329921
0
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Impaired communication
329922
0
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Sarcopenia
329923
0
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impaired physical functioning
329924
0
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Radiotherapy
329925
0
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weak swallowing function
330514
0
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Condition category
Condition code
Cancer
326827
326827
0
0
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Head and neck
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Diet and Nutrition
327361
327361
0
0
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Other diet and nutrition disorders
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Mental Health
327362
327362
0
0
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Other mental health disorders
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Oral and Gastrointestinal
327363
327363
0
0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Musculoskeletal
327364
327364
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients with head and neck cancer planned for radiotherapy will receive screening for risk of physical and psychological concerns. All patients planned for radiotherapy will receive Preparing for Head and Neck Radiotherapy (Prep-4-RT) self-management resources. Patients who are identified in the high risk range for psychological distress, malnutrition, sarcopenia, eating difficulties or poor physical functioning, will be referred for a one-on-one appointment with a psychologist, dietitian, speech pathologist or physiotherapist for specialist prehabilitation. Feasibility and acceptability data of the self-management and specialist prehabilitation pathways will be collected.
SELF-MANAGEMENT
The Prep-4-RT resources comprise of 5 webpages on the following topics: Introduction to Prehabilitation; What to expect?; How to prepare?; Guide to feeding tubes; Guidance for carers and support people. Each webpage has a short video with information from clinicians and consumers, as well as written and pictorial information sheets and links to relevant resources. It is anticipated participants will need between 30 to 60 minutes to review the resources. These resources are readily available at: www.petermac.org/Prep-4-RT. Webpage analytics will be monitored to provide an indication of webpage access, usage and adherence.
SPECIALIST PREHABILITATION:
Screening for specialist prehabilitation was a short online survey completed on an ipad with a head and neck nurse consultant as part of the clinical interview at the first nursing appointment. The survey is estimated to take 5-10 minutes. Screening will be completed within 7 days of enrolment. Enrolment is the day patients are identified as planned for radiotherapy treatment. One-on-one appointments with specialist clinicians are anticipated to have a duration of between 30-60 minutes. A one-on-one appointment will be provided with each specialist discipline for which a participant meets the high risk criteria (e.g. scoring high risk for malnutrition and mental health would trigger one-on-one prehabilitation with a dietitian and psychologist). The timing of the appointments is that at least one appointment is provided prior to commencing radiotherapy with additional appointments scheduled as clinically indicated. Adherence to specialist prehabilitation appointments will be monitored by audit of appointment attendance, compliance and barriers to engagement.
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Intervention code [1]
326030
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Behaviour
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Intervention code [2]
326432
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Treatment: Other
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Comparator / control treatment
No control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Participant satisfaction with the self-management resources and specialist prehabilitation pathways assessed using the Client Satisfaction Questionnaire..
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Assessment method [1]
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Timepoint [1]
334684
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Prior to radiotherapy at the end of the prehabilitation period
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Primary outcome [2]
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Participant acceptability of the self-management resources and specialist prehabilitation pathways assessed using the Theoretical Framework of Acceptability.
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Assessment method [2]
335232
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Timepoint [2]
335232
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Prior to radiotherapy at the end of the prehabilitation period
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Primary outcome [3]
335233
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Patient uptake as measured by the number of patients who consent to screening as per medical records.
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Assessment method [3]
335233
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Timepoint [3]
335233
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Prior to radiotherapy at the end of the prehabilitation period
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Secondary outcome [1]
421643
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Participant intention to try the intervention as measured by the number of patients who utilise the self-management resources (as self-reported in study-designed questions and website analytics) and number of patients who accept the referral to specialist prehabilitation.
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Assessment method [1]
421643
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Timepoint [1]
421643
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Prior to radiotherapy at the end of the prehabilitation period
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Secondary outcome [2]
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Participant adherence to specialist prehabiltiation measured by attendance at appointments (as per medical record).
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Assessment method [2]
423560
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Timepoint [2]
423560
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Prior to radiotherapy at the end of the prehabilitation period
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Secondary outcome [3]
423561
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Staff acceptability of the model of care assessed using the Theoretical Framework of Acceptability.
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Assessment method [3]
423561
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Timepoint [3]
423561
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Prior to radiotherapy at the end of the prehabilitation period
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Eligibility
Key inclusion criteria
• Be aged 18 years or older at the time of recruitment
• Be able to speak and read English
• Be able to give informed consent (i.e., no psychiatric/cognitive condition that would impact informed consent, as based on clinical judgement)
• Be planned for radiotherapy for HNC
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Planned for palliative radiotherapy (e.g., less than 40Gy)
• Reporting extreme distress (e.g., risk of harm to themselves or psychotic symptoms)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
Descriptive statistics will be used to summarise participant demographic and clinical characteristics of all participants screened. Statistics will include counts and percentages for nominal and crude-scale ordinal valued variables; and means and standard deviations or medians and interquartile ranges, as appropriate, for fine-scale ordinal and continuous valued variables. Descriptive statistics will also be used to summarise operational and self-reported data relevant to evaluation outcomes.
Acceptability, satisfaction, adoption, and fidelity of the Prep-4-RT model of care will be summarised using descriptive statistics. The evaluation of acceptability, adoption and fidelity will be assessed by calculating percentages of participants who completed screening, percentage of participants who consented to evaluation, the percentage who accessed the self-management resources, adherence to program protocol, and clinician time to deliver the screening and interventions. Free text items from participant questionnaires will be summarised using content analysis, whereby the content of free responses will be coded and grouped, where applicable.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
9/03/2023
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Date of last participant enrolment
Anticipated
28/07/2023
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Actual
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Date of last data collection
Anticipated
1/09/2023
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Actual
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Sample size
Target
60
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Accrual to date
30
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
24680
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment postcode(s) [1]
40300
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3000 - Melbourne
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Funding & Sponsors
Funding source category [1]
313787
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Government body
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Name [1]
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Western and Central Melbourne Integrated Cancer Service
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Address [1]
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2 St Andrews Pl, East Melbourne, Victoria 3002
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Country [1]
313787
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Australia
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Primary sponsor type
Hospital
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Name
Peter MacCallum Cancer Centre
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Address
305 Grattan St, Melbourne, Vicotria, 3000
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Country
Australia
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Secondary sponsor category [1]
315661
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None
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Name [1]
315661
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Address [1]
315661
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Country [1]
315661
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
312955
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Peter MacCallum Cancer Centre Human Research Ethics Committee
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Ethics committee address [1]
312955
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305 Grattan St, Melbourne, Victoria, 3000
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Ethics committee country [1]
312955
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Australia
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Date submitted for ethics approval [1]
312955
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Approval date [1]
312955
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18/07/2022
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Ethics approval number [1]
312955
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HREC/86559/PMCC
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Summary
Brief summary
The aim of this study is to evaluate a multimodal prehabilitation model of care, designed to support patients with head and neck cancer (HNC) to prepare for the physical and psychological impacts of radiotherapy (RT). Who is it for? You may be eligible for this study if you are aged 18 years or older and you are scheduled to receive radiotherapy as a treatment for your head and neck cancer. Study details All participants who choose to enrol in this study will be asked to complete a screening survey at a routine appointment with their specialist nurse consultant. This screening will involve completing a series of questionnaires. It is anticipated that this screening survey will take 5-10 minutes to complete. All participants will then receive access to the 'Preparing for Head and Neck Radiotherapy (Prep-4-RT)' self-management resources created by the Peter MacCallum Cancer Centre. Participants will be encouraged to engage with the resources at least once prior to their scheduled radiotherapy sessions. Information provided in the resources includes videos, written and pictorial information sheets and links to other relevant resources on the topics of “introducing prehabilitation”, “what is it like to go through radiotherapy?”, “preparing for radiotherapy: how do you do it?”, “guide to feeding tubes” and “guidance for carers and support people”. If during the screening process any participants are identified to be at risk of psychological distress, malnutrition, sarcopenia, eating difficulties or poor physical functioning, they will also be referred for a one-on-one appointment with a psychologist, dietitian, speech pathologist or physiotherapist for specialist prehabilitation. At least one appointment with each of the required disciplines will be scheduled prior to the participant's first radiotherapy treatment session and further appointments will be scheduled as clinically indicated. It is hoped this research will determine whether the self-managed patient resources and specialist prehabilitation sessions are acceptable to patients with head and neck cancer and the staff involved in their care. If these processes are found to be acceptable and helpful to patients and staff, a larger trial of these care pathways may be trialled in a greater number of patients.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Ms Jenelle Loeliger
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Address
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Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, Victoria, 3000
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Country
126470
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Australia
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Phone
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+61 3 85595221
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Fax
126470
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Email
126470
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[email protected]
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Contact person for public queries
Name
126471
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Jenelle Loeliger
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Address
126471
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Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, Victoria, 3000
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Country
126471
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Australia
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Phone
126471
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+61 3 85595221
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Fax
126471
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Email
126471
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[email protected]
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Contact person for scientific queries
Name
126472
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Jenelle Loeliger
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Address
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Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, Victoria, 3000
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Country
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Australia
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Phone
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+61 3 85595221
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Fax
126472
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Email
126472
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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