Camilla Zimmermann, MD, PhD, FRCPC

Pilot trial of virtual and in-person Symptom screening with Targeted Early Palliative care (STEP2)

Study Status: Active

Study Purpose: The purpose of this study is to determine if our virtual and in-person “Symptom screening with Targeted Early Palliative care” (STEP2) intervention is practical, and how a larger study should be planned.

Background: Palliative care teams are experts in pain and symptom care and focus on improving quality of life for patients with serious illness and their families. However, due to limited resources, most patients do not have early access to outpatient palliative care alongside their usual cancer care. Our team has developed a new way to identify patients with the greatest need for early palliative care (i.e. those with higher symptom scores). This system is called STEP (Symptom screening with Targeted Early Palliative care). The system uses electronic information patients report about their symptoms before each oncology clinic visit.

Study Methods: Study participants include adult patients with advanced cancer who attend medical oncology clinics at the Princess Margaret Cancer Centre and who have not yet been referred to a palliative care team. Patients who consent to participate will complete questionnaires about their quality of life, symptom control, mood, satisfaction with care, anxiety, and general health status. Questionnaires are completed at the start of the study and after 2, 4 and 6 months. Patients are asked to complete a short questionnaire about their symptoms online up to 48 hours ahead of their oncology visits. Patients who report moderate to high symptom scores at any time during the 6 months are enrolled in the study. The online tool emails the study team automatically. A study nurse will then call these patients to discuss their symptoms and offer a referral for an in-person or virtual visit to the outpatient palliative care clinic at the Princess Margaret. The outpatient palliative care team can help with pain and symptom management, coping and support, arranging care in the home as needed, and planning for the future, alongside their usual cancer care. Those who agree to this referral are offered at least monthly in-person and/or virtual palliative care clinic follow-up visits. This continues until the study ends and is based on patient needs and care provider preference. Additionally, all participants will be offered a chance to participate in a one-time one-on-one study interview with a study staff member during the study. These interviews will explore factors patients considered (or would consider) when deciding to accept or defer the outpatient palliative care clinic referral.

Health Conditions: Cancer,Palliative Care