Clinical trial NCT05974787: Potential Improvements in the Pre-emergency Department Care for Cancer Patients
Official title: Identification of Potential Improvements in the Acute Care Pathway for Cancer Patients in the Emergency Department (OVERSEE - I Trial)
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cancer
Emergencies
Lead sponsor: Erasmus Medical Center
Sponsor class: OTHER
First posted: 2023-08-03
Enrollment: 75
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: In the emergency department (ED) of Erasmus medical center (MC) yearly around 1600 patients with cancer are presented to the ED. Based on the study design we will conduct interviews with 75 to 100 patients with solid and hematologic malignancies, who are receiving systemic therapy or have received systemic therapy within the last 3 months and are admitted to the ED department of the Erasmus MC for the oncology, hematology, lung- and neuro-oncology medical unit. If present, the interview will also be held with the family caregiver.

Brief summary: The goal of this single center prospective cross-sectional study is to identify the facilitators and barriers in the course of the disease that starts when symptoms first arise until patients with solid and hematologic malignancies arrive in the emergency department (ED). The main question it aims to answer are: Is there a potential relation between the lag-time and the ED length of stay (LOS) and the chance of admission. Participants will be asked to participate in a one-time interview, that focusses on the pre-admission process.

Detailed description: The goal of this single center prospective cross-sectional study is to identify the facilitators and barriers in the course of the disease that starts when symptoms first arise until patients with solid and hematologic malignancies arrive in the emergency department (ED). The main question it aims to answer are: Is there a potential relation between the lag-time and the emergency department length of stay and the chance of admission. Participants will be asked to participate in a one-time interview, that focusses on the pre-admission process. The interview focuses on several parts of the (pre-)admission process: The first part is regarding the timeline that led to an ED visit. The investigators will establish, when and which symptoms were first detected. The second part are regarding the number and type of health care workers that were contacted before visiting the ED. The third part will be about the actions that were taken before the ED visit.

Eligibility criteria: Inclusion criteria:

* Patients with solid or hematological malignancies and receiving systemic therapy or having received systemic therapy within the last 3 months.
* Presented at or admitted from the emergency department for the oncology, hematology, neuro- or lung-oncology clinical unit.
* Awake and conscious.
* Possible to answer questions within 48 hours after presentation at the emergency department (ED).

Exclusion Criteria:

* \<18 years old
* Only received a surgical intervention as cancer treatment
* Admitted to the ED for the surgical department
* Not willing or able to give written informed consent

Primary outcomes:
measure: Clusters of facilitators experienced by cancer patients.
timeFrame: Through study completion, an average of 6 months
measure: clusters of barriers experienced by cancer patients.
timeFrame: Through study completion, an average of 6 months
Secondary outcomes:
measure: Time-to-speak
timeFrame: Through study completion, an average of 6 months
measure: Time-to-contact
timeFrame: Through study completion, an average of 6 months
measure: Time-to-present
timeFrame: Through study completion, an average of 6 months
measure: Difference in group average lag-time between day, evening and night
timeFrame: Through study completion, an average of 6 months
measure: Difference in group average lag-time between weekdays (Monday 08:00 till Friday 23:59) and weekend (Saturday 00:00 and Monday 7:59)
timeFrame: Through study completion, an average of 6 months
measure: Correlation between number of contacted healthcare providers before presentation at the ED and the lag- time.
timeFrame: Through study completion, an average of 6 months
measure: Willingness to participate
timeFrame: Through study completion, an average of 6 months
measure: Lag-time
timeFrame: Through study completion, an average of 6 months
measure: ED length of stay (LOS)
timeFrame: Through study completion, an average of 6 months
measure: Disposition
timeFrame: Through study completion, an average of 6 months
measure: Patient characteristics
timeFrame: Through study completion, an average of 6 months
measure: Correlation between lag-time and ED-LOS
timeFrame: Through study completion, an average of 6 months
measure: Correlation between lag-time and disposition
timeFrame: Through study completion, an average of 6 months
measure: Correlation between lag-time and patient characteristics
timeFrame: Through study completion, an average of 6 months
measure: ED crowding
timeFrame: Through study completion, an average of 6 months
Other outcomes:
Locations:
city: Rotterdam
country: Netherlands
facility: Erasmus MC
state: Zuid-Holland
Study officials:
affiliation: Erasmus Medical Center
name: Jason den Duijn
role: PRINCIPAL_INVESTIGATOR
References: