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Palliative CareNCT03466580

Improvement of Support to Caregivers of Patients in Specialized Palliative Care at Home

A study testing The Carer Support Needs Assessment Tool (CSNAT) intervention in people with Palliative Care, run by Bispebjerg Hospital at 10 sites in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of the project is to evaluate the use of the caregiver-led 'CSNAT intervention' to identify, prioritize and address support needs among caregivers of patients who are starting in specialized palliative care at home in Denmark Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Palliative Care
What is being tested?
The Carer Support Needs Assessment Tool (CSNAT) intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
466 participants
Where
10 sitesDenmark
Study dates
15 Mar 2018to 31 Dec 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • The caregiver and patient should be able to read and understand Danish
  • The caregiver and patient should give written informed consent
  • The patient should be newly referred to specialized palliative care (SPC) in the SPC unit.

Who cannot join

  • The caregiver is viewed by the practitioners as being too distressed to be asked about participation
  • The caregiver has a known cognitive impairment precluding participation (based on the practitioners' clinical judgement)

Trial locations and contacts

10 sites in 1 country.

10 sites in 1 country

Denmark10 sites
  • Department of Palliative Medicine, Bispebjerg Hospital

    Copenhagen NV, DK-2400

  • The Palliative unit, Rigshospitalet

    Copenhagen O, DK-2100

  • Diakonissestiftelsens Hospice

    Frederiksberg, DK-2000

  • The Palliative Unit, Nordsjaellands Hospital

    Frederikssund, DK-3600

  • Arresoedal Hospice

    Frederiksværk, DK-3300

  • The Palliative Unit, Amager-Hvidovre Hospital

    Hvidovre, DK-2650

  • Hospice Soendergaard

    Maaloev, DK-2760

  • Palliative Team Fyn, OUH

    Odense C, DK-5000

  • The Palliative Team NORTH, University Hospital Sjaelland

    Roskilde, DK-4000

  • Palliative Team, Hospital Soenderjylland

    Sønderborg, DK-6400

Other trials in Denmark

About this study

Official title: Testing a Caregiver-led Intervention to Improve Support to Caregivers of Patients in Specialized Palliative Care at Home: a Stepped Wedge (Cluster) Randomized Controlled Trial

The aim of the project is to evaluate the use of the caregiver-led 'CSNAT intervention' to identify, prioritize and address support needs among caregivers of patients who are starting in specialized palliative care at home in Denmark

Conditions
Palliative Care
Being tested
The Carer Support Needs Assessment Tool (CSNAT) intervention
Keywords
Caregivers, Support needs, Intervention, Randomised controlled trial

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • The Carer Support Needs Assessment Tool (CSNAT) interventionBehavioural

    The CSNAT intervention is a caregiver-led approach where the caregiver first identifies his/her needs of support in the CSNAT, which consists of 14 support domains. Then the practitioner facilitates the intervention where the caregiver prioritizes which domains to discuss. In the conversation, the caregiver's domain priorities and subsequently identified support needs are discussed with the practitioner to agree on actions/solutions and a shared action plan. The intervention will be offered each caregiver twice: the first time between 0 and 13 days after enrollment, and the second time between 15 and 27 days after enrollment.

Study groups in NCT03466580
Study groupRoleWhat they receive
InterventionExperimental('Standard' specialized palliative care +) The Carer Support Needs Assessment Tool (CSNAT) intervention.
Receives: Behavioral: The Carer Support Needs Assessment Tool (CSNAT) intervention
ControlNo intervention('Standard' specialized palliative care). No intervention offered.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Caregiver strain

    Caregiver strain is measured by the subscale 'Caregiver Strain' in the Family Appraisal of Caregiving Questionnaire for Palliative Care (FACQ-PC). Subscale score range: 1-5. A higher score represents a worse outcome, i.e. more caregiver strain.

    Measured: Change from baseline (enrollment) to day 14

Secondary outcomes (32)
  1. Caregiver strain

    Caregiver strain is measured by the subscale 'Caregiver Strain' in the Family Appraisal of Caregiving Questionnaire for Palliative Care (FACQ-PC). Subscale score range: 1-5. A higher score represents a worse outcome, i.e. more caregiver strain.

    Measured: Change from baseline (enrollment) to day 28

  2. Positive caregiving appraisals

    Positive caregiving appraisals is measured by the subscale 'Positive caregiving appraisals' in the Family Appraisal of Caregiving Questionnaire for Palliative Care (FACQ-PC). Subscale score range: 1-5. A higher score represents a better outcome, i.e. more positive caregiving appraisals.

    Measured: Change from baseline (enrollment) to day 14

  3. Positive caregiving appraisals

    Positive caregiving appraisals is measured by the subscale 'Positive caregiving appraisals' in the Family Appraisal of Caregiving Questionnaire for Palliative Care (FACQ-PC). Subscale score range: 1-5. A higher score represents a better outcome, i.e. more positive caregiving appraisals.

    Measured: Change from baseline (enrollment) to day 28

  4. Caregiver distress

    Caregiver distress is measured by the subscale 'Caregiver distress' in the Family Appraisal of Caregiving Questionnaire for Palliative Care (FACQ-PC). Subscale score range: 1-5. A higher score represents a worse outcome, i.e. more caregiver distress.

    Measured: Change from baseline (enrollment) to day 14

  5. Caregiver distress

    Caregiver distress is measured by the subscale 'Caregiver distress' in the Family Appraisal of Caregiving Questionnaire for Palliative Care (FACQ-PC). Subscale score range: 1-5. A higher score represents a worse outcome, i.e. more caregiver distress

    Measured: Change from baseline (enrollment) to day 28

  6. Satisfaction with attention from health care professionals

    Measured by the subscale 'Lack of attention from health care professionals on the caregivers' wellbeing' in the Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Subscale score range: 0-100. A higher score represents a worse outcome, i.e. more lack of attention from health care professionals

    Measured: Change from baseline (enrollment) to day 14

  7. Satisfaction with attention from health care professionals

    Measured by the subscale 'Lack of attention from health care professionals on the caregivers' wellbeing' in the Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Subscale score range: 0-100. A higher score represents a worse outcome, i.e. more lack of attention from health care professionals

    Measured: Change from baseline (enrollment) to day 28

  8. Satisfaction with communication with health care professionals

    Measured by the subscale 'Problems with the quality of information from and communication with health care professionals' in the Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Subscale score range: 0-100. A higher score represents a worse outcome, i.e. more problems with the quality of information from and communication with health care professionals

    Measured: Change from baseline (enrollment) to day 14

  9. Satisfaction with communication with health care professionals

    Measured by the subscale 'Problems with the quality of information from and communication with health care professionals' in the Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Subscale score range: 0-100. A higher score represents a worse outcome, i.e. more problems with the quality of information from and communication with health care professionals

    Measured: Change from baseline (enrollment) to day 28

  10. Satisfaction with information from health care professionals

    Measured with selected items from the subscale 'Lack of information from health care professionals' in the Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Item/subscale score range: 0-100. A higher score represents a worse outcome, i.e. more lack of information from health care professionals

    Measured: Change from baseline (enrollment) to day 14

  11. Satisfaction with information from health care professionals

    Measured with selected items from the subscale 'Lack of information from health care professionals' in the Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Item/subscale score range: 0-100. A higher score represents a worse outcome, i.e. more lack of information from health care professionals

    Measured: Change from baseline (enrollment) to day 28

  12. Caregiving workload

    Measured with selected items from the subscale 'Caregiving workload' in the Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Item/subscale score range: 0-100. A higher score represents a worse outcome, i.e. more caregiving workload

    Measured: Change from baseline (enrollment) to day 14

  13. Caregiving workload

    Measured with selected items from the subscale 'Caregiving workload' in the Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Item/subscale score range: 0-100. A higher score represents a worse outcome, i.e. more caregiving workload

    Measured: Change from baseline (enrollment) to day 28

  14. Caregiver involvement

    Measured with item 12 in the Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Item score range: 0-100. A higher score represents a worse outcome, i.e. more caregiver dissatisfaction with involvement

    Measured: Change from baseline (enrollment) to day 14

  15. Caregiver involvement

    Measured with item 12 in the Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). Item score range: 0-100. A higher score represents a worse outcome, i.e. more caregiver dissatisfaction with involvement

    Measured: Change from baseline (enrollment) to day 28

  16. Help from health care professionals

    Measured with two newly developed items which ask whether the health care professionals have talked with the caregiver about what burdens them, and whether the health care professionals have helped with these burdens. Item score range: 0-100. A higher score represents a worse outcome, i.e. less help from health care professionals

    Measured: Change from baseline (enrollment) to day 14

  17. Help from health care professionals

    Measured with two newly developed items which ask whether the health care professionals have talked with the caregiver about what burdens them, and whether the health care professionals have helped with these burdens. Item score range: 0-100. A higher score represents a worse outcome, i.e. less help from health care professionals

    Measured: Change from baseline (enrollment) to day 28

  18. Quality of life

    Measured by the two items assessing overall health and quality of life in the EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Item score range: 0-100. A higher score represents a better outcome, i.e. better quality of life

    Measured: Change from baseline (enrollment) to day 14

  19. Quality of life

    Measured by the two items assessing overall health and quality of life in the EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Item score range: 0-100. A higher score represents a better outcome, i.e. better quality of life

    Measured: Change from baseline (enrollment) to day 28

  20. Emotional functioning

    Measured by the four emotional functioning items in EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) supplemented with three selected items from the EORTC Computerized Adaptive Test (CAT) emotional functioning item bank. Item/subscale score range: 0-100. A higher score represents a better outcome, i.e. better emotional functioning

    Measured: Change from baseline (enrollment) to day 14

  21. Emotional functioning

    Measured by the four emotional functioning items in EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) supplemented with three selected items from the EORTC Computerized Adaptive Test (CAT) emotional functioning item bank. Item/subscale score range: 0-100. A higher score represents a better outcome, i.e. better emotional functioning

    Measured: Change from baseline (enrollment) to day 28

  22. Fatigue

    Measured by the three fatigue items in EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) supplemented with three selected items from the EORTC Computerized Adaptive Test (CAT) fatigue item bank. Item/subscale score range: 0-100. A higher score represents a worse outcome, i.e. more fatigue

    Measured: Change from baseline (enrollment) to day 14

  23. Fatigue

    Measured by the three fatigue items in EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) supplemented with three selected items from the EORTC Computerized Adaptive Test (CAT) fatigue item bank. Item/subscale score range: 0-100. A higher score represents a worse outcome, i.e. more fatigue

    Measured: Change from baseline (enrollment) to day 28

  24. Positive emotional functioning

    Measured by five positively formulated items concerning emotional functioning which were excluded from the EORTC Computerized Adaptive Test (CAT) emotional functioning bank during the development of the item bank. Item score range: 0-100. A higher score represents a better outcome, i.e. more positive emotional functioning

    Measured: Change from baseline (enrollment) to day 14

  25. Positive emotional functioning

    Measured by five positively formulated items concerning emotional functioning which were excluded from the EORTC Computerized Adaptive Test (CAT) emotional functioning bank during the development of the item bank. Item score range: 0-100. A higher score represents a better outcome, i.e. more positive emotional functioning

    Measured: Change from baseline (enrollment) to day 28

  26. Caregiver grief

    Measured by the Prolonged Grief Scale-13 (PG-13). Symptom subscale score range: 9-45. A higher score represents a worse outcome, i.e. higher level of prolonged grief symptoms

    Measured: Measured six months after the patient's death

  27. Acute hospitalizations

    Number of acute patient hospitalizations

    Measured: From enrollment to day 14

  28. Acute hospitalizations

    Number of acute patient hospitalizations

    Measured: From enrollment to day 28

  29. Hospice referrals (for in-patient care)

    Number of patients referred to hospice in-patient care

    Measured: From enrollment to day 14

  30. Hospice referrals (for in-patient care)

    Number of patients referred to hospice in-patient care

    Measured: From enrollment to day 28

  31. Survival time

    Number of days the patient lives

    Measured: From enrollment to up to six months after the project recruitment period has closed

  32. Place of death

    The place in which the patient dies

    Measured: From enrollment to up to six months after the project recruitment period has closed

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Mar 2018
  2. Study start15 Mar 2018
  3. Primary completion31 Jul 2019
  4. Study completion31 Dec 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
A stepped wedge cluster randomized controlled trial. All clusters (i.e., specialized palliative care (SPC) units) will start as controls and will change to intervention at various times determined by randomization. In this way, all SPC units will contribute to control and intervention groups, thus accounting for variation between SPC units.
Masking
None (open label)
Enrolment
466 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03466580
Sponsor's protocol ID
R137-A8861
Status last verified
Jan 2021
First submitted
1 Mar 2018
Last updated
27 Jan 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lund L, Ross L, Petersen MA, Rosted E, Bollig G, Juhl GI, Farholt H, Winther H, Laursen L, Blaaberg EG, Weensgaard S, Guldin MB, Ewing G, Grande G, Groenvold M. Process, content, and experiences of delivering the Carer Support Needs Assessment Tool Intervention (CSNAT-I) in the Danish specialised palliative care setting. Support Care Cancer. 2022 Jan;30(1):377-387. doi: 10.1007/s00520-021-06432-1. Epub 2021 Jul 23.

    PubMed 34296334
  • Lund L, Ross L, Petersen MA, Blach A, Rosted E, Bollig G, Juhl GI, Farholt HB, Winther H, Laursen L, Hasse M, Weensgaard S, Guldin MB, Ewing G, Grande G, Groenvold M. Effect of the Carer Support Needs Assessment Tool intervention (CSNAT-I) in the Danish specialised palliative care setting: a stepped-wedge cluster randomised controlled trial. BMJ Support Palliat Care. 2020 Oct 28:bmjspcare-2020-002467. doi: 10.1136/bmjspcare-2020-002467. Online ahead of print.

    PubMed 33115831

Questions about this trial

What is this clinical trial studying?

A study testing The Carer Support Needs Assessment Tool (CSNAT) intervention in people with Palliative Care, run by Bispebjerg Hospital at 10 sites in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Caregiver strain (time frame: Change from baseline (enrollment) to day 14). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03466580, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jan 2021.

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