BRIDGE: Proactive Psychiatry Consultation and Case Management for Patients With Cancer

Study Description

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

The purpose of this research is to understand if it is helpful for patients with mental illness to be connected to a psychiatrist and case manager at the time of cancer diagnosis.

Condition or disease	Intervention/treatment	Phase
Cancer; Severe Major Depression; Schizophrenia; Bipolar Disorder; Lung Cancer; Breast Cancer; Head and Neck Cancer; Gastrointestinal Cancer	Other: Proactive Psychiatry Consultation	Not Applicable

Detailed Description:

It is challenging to cope with cancer. The investigators want to understand if it is helpful for patients with serious mental illness (SMI) to be connected to a psychiatrist and case manager when cancer is diagnosed. Many people with illnesses like major depression, schizophrenia and bipolar disorder face barriers to receiving high quality cancer care. It can be difficult to get to appointments, have many different doctors, and experience depression or worry. Better communication between the patient, the oncology team, and mental health providers may improve care. As for all patients, it is important for people with mental illness to have access to high quality cancer treatment that is patient-centered and coordinated. Having a case manager and psychiatrist at the cancer center who collaborates with the oncology team starting at cancer diagnosis may help patients to receive the cancer care that they need. This single-arm open pilot study will enable the study team to pilot patient measures (engagement and satisfaction in care, psychiatric and cancer-related symptoms) and caregiver measures (engagement and satisfaction in care, caregiver burden, and mastery) and refine the intervention manual before conducting a randomized controlled trial (17-396-RCT).

Study Design

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Study Type :	Interventional (Clinical Trial)
Estimated Enrollment :	9 participants
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Supportive Care
Official Title:	BRIDGE: Proactive Psychiatry Consultation and Case Management for Patients With Cancer
Actual Study Start Date :	December 11, 2017
Estimated Primary Completion Date :	March 30, 2018
Estimated Study Completion Date :	July 30, 2018

Arms and Interventions

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Arm

Intervention/treatment

Experimental: Proactive Psychiatry Consultation (PPC); Proactive Psychiatry Consultation and Case Management is: Patient-centered: Based on the patient's needs, the team aims to build a relationship, increase engagement, and promote continuity.; Team-based: A psychiatrist and case manager identify goals for cancer treatment, assess psychiatric history and symptoms with a focus on impact on cancer care, collaborate with community-based clinicians and caregivers, and address barriers to care.; Integrated into cancer care delivery: The psychiatry and oncology teams collaborate starting at cancer diagnosis to support patient through cancer treatment.; Systematic: The team monitors psychiatric and cancer-related symptoms and cancer care delivery to measure progress toward goals and rapidly adjust treatment as needed.

Other: Proactive Psychiatry Consultation; Proactive Psychiatry Consultation and Case Management aims to improve communication among the patient, oncology team, and mental health clinicians, and increase engagement of family and community caregivers, which may help patients to receive the cancer care they need.

Outcome Measures

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Primary Outcome Measures :

1. Feasibility of intervention delivery [ Time Frame: 12 weeks ]

   60% of enrolled patients complete the intervention:

   1. Patient completes interdisciplinary assessment and has at least 2 additional interactions with the intervention team
   2. Intervention team communicates with oncology team at least once
   3. If caregiver identified, intervention team communicates with caregiver at least once

Secondary Outcome Measures :

1. Acceptability of the intervention [ Time Frame: 12 weeks ]
   The intervention will be evaluated as acceptable to patients if 60% of patients rate the intervention as acceptable (at least 4/5 on a 5 point scale) in exit surveys

Eligibility Criteria

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Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Patient Inclusion Criteria:

• Age > 18 years old
• Verbal fluency in English
• SMI (Schizophrenia spectrum disorder, bipolar disorder, or major depressive disorder with prior psychiatric hospitalization) confirmed by diagnostic evaluation of study psychiatrist
• Invasive breast, lung, gastrointestinal, or head and neck cancer (suspected or confirmed according to documentation by the oncologist or pathology)
• Oncology consultation at Massachusetts General Hospital (MGH) Cancer Center within the past 8 weeks

Patient Exclusion Criteria:

• Have cognitive impairment severe enough to interfere with completing brief study assessments or providing informed consent (and does not have a guardian who can provide consent)
• Refuse participation

Caregiver Participants

• Age > 18 years old
• Verbal fluency in English
• Family or community-based caregiver who accompanies the patient to medical appointments or participates in decision-making about cancer care
• Patient participant identifies or confirms caregiver's involvement, provides permission to contact caregiver

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Contacts

Contact: Kelly E Irwin, MD	617-643-4453	keirwin@partners.org

Locations

United States, Massachusetts
Massachusetts General Hospital	Recruiting
Boston, Massachusetts, United States, 02114
Contact: Kelly E Irwin, MD 617-643-4453 keirwin@partners.org
Principal Investigator: Kelly E Irwin, MD

Sponsors and Collaborators

Massachusetts General Hospital

Harvard Risk Management Foundation

Investigators

Principal Investigator:	Kelly E Irwin, MD	Massachusetts General Hospital

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Responsible Party:	Kelly Edwards Irwin, Principal Investigator, Massachusetts General Hospital
ClinicalTrials.gov Identifier:	NCT03360695 History of Changes
Other Study ID Numbers:	17-396
First Posted:	December 4, 2017
Last Update Posted:	February 1, 2018
Last Verified:	January 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:	No

Studies a U.S. FDA-regulated Drug Product:		No
Studies a U.S. FDA-regulated Device Product:		No

Keywords provided by Kelly Edwards Irwin, Massachusetts General Hospital:

Cancer Care; Major Depression and Cancer; Schizophrenia and Cancer; Bipolar Disorder and Cancer; Lung Cancer; Breast Cancer	Head and Neck Cancer; Gastrointestinal Cancer; Schizophrenia; Bipolar Disorder; Major Depression

Additional relevant MeSH terms:

Depression; Schizophrenia; Head and Neck Neoplasms; Bipolar Disorder; Depressive Disorder, Major; Gastrointestinal Neoplasms; Behavioral Symptoms; Schizophrenia Spectrum and Other Psychotic Disorders; Mental Disorders	Neoplasms by Site; Neoplasms; Bipolar and Related Disorders; Depressive Disorder; Mood Disorders; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases