Providing Cancer Care Closer to Home for Patients With Multiple Myeloma

Study Overview
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Brief Summary
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There is very limited data on the utilization of National Cancer Institute Comprehensive Cancer Center (NCI-CCC) satellite sites in general. Of what is available, most is in regards to providing chemotherapy at facilities closer to patients' home. These satellite chemotherapy infusion centers, typically community-based treatment locations at community hospitals/facilities, freestanding clinics, or mobile units, are reported to be well liked by patients who utilize their services and reduce their travel times and expenses. In these studies patients still remained in the care of their current provider and site and are required to travel to the site for clinical visits and other appointments. It is currently unknown if patients are willing to transfer their care to a different provider to alleviate travel burden. In addition, although increased travel burden has been lower quality of life in cross-sectional studies, no data exists suggesting that these reducing travel burden can improve these outcomes intra-patient, to the knowledge of the investigators. The patient roles of the multiple myeloma clinical providers at the Siteman primary location have grown in recent years. The providers have determined a need to refer some patients to the satellite sites to relieve congestion at the site while also hopefully improving the clinical experience for those patients. This study is a natural experiment of this process.

Official Title
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A Natural Experiment of Providing Cancer Care Closer to Home for Patients With Multiple Myeloma

Conditions
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Multiple Myeloma

Intervention / Treatment
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* Other: Care transition
* Other: No care transition


Participation Criteria
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Eligibility Criteria
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Eligibility Criteria At least 18 years old Diagnosed with multiple myeloma Receiving care from a provider within the Division of Oncology at the primary Siteman Cancer Center site Resides within the catchment area of a Siteman Cancer Center satellite site Able to read, speak, and understand English Willing to provide informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Care transition<br>-At baseline, the participant and the provider will make a decision on if the participant will transfer care to a satellite location. | Other: Care transition<br>* Cancer care is transitioned to a satellite site.<br>|
| Active Comparator: No care transition<br>-At baseline, the participant and the provider will make a decision on if the participant will transfer care to a satellite location. | Other: No care transition<br>* Cancer care is not transitioned to a satellite site.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of eligible participants who successfully transfer to the provider at a satellite location |  | At time of transfer decision (day 1) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Types of candidacy that providers use for transfer of care to satellite sites | Qualitative data collection | At time of transfer decision (day 1) | 
| Treatment burden of participants as measured by the Modified Treatment Burden Questionnaire | Explore differences in participant experience between those that elect to transfer to a satellite site and those who decline to transfer. The Modified Treatment Burden Questionnaire will be completed at baseline (time of transfer decision) and again approximately 6 months later. There are 3 questions with answers ranging from 0 (not a problem) to 10 (big problem). The higher the score the more treatment burden the participant experienced. | Through completion of follow-up (estimated to be 6 months) | 
| Satisfaction of with participant-provider interactions as measured by the Questionnaire on the Quality of Physician-Patient Interaction | Explore differences in participant satisfaction between those that elect to transfer to a satellite site and those who decline to transfer. The Questionnaire on the Quality of Physician-Patient Interaction will be completed at baseline (time of transfer decision) and again approximately 6 months later. There are 14 questions with answers ranging from 1 (do not agree) to 5 (I fully agree). The higher the score the higher the quality of the physician-patient interactions. | Through completion of follow-up (estimated to be 6 months) | 
| Financial toxicity of participants as measured by the Comprehensive Score for Financial Toxicity | Explore differences in participant financial toxicity between those that elect to transfer to a satellite site and those who decline to transfer. The Comprehensive Score for Financial Toxicity will be completed at baseline (time of transfer decision) and again approximately 6 months later. There are 11 questions with answers ranging from 0 (not at all) to 4 (very much). The higher the score the less financial toxicity the participant experienced. | Through completion of follow-up (estimated to be 6 months) | 
| Participant rationales for opting to transfer to a satellite site or maintain care at their usual site. | A sample of 20 patients, approximately 10 who decided to transfer and 10 who declined, will be surveyed in regards to the reason(s) for their decision as part of a sub-study. Patients who were not enrolled in the prospective portion of the study, either due to declining or not approached, will be allowed to enroll in the sub-study as long as they were offered the ability to transfer to a satellite site by their provider. | Through completion of follow-up (estimated to be 6 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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access to care, travel burden, financial toxicity, patient satisfaction