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Trial registered on ANZCTR
Registration number
ACTRN12616000601437
Ethics application status
Approved
Date submitted
8/04/2016
Date registered
10/05/2016
Date last updated
13/12/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Supporting the provision of palliative care in the home environment: a proof of concept study
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Scientific title
Supporting the provision of palliative care in the home environment: A proof of concept study of a palliative carers education package (PrECEPt)
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Secondary ID [1]
288924
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
PrECPt
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Palliative care in the home environment
298259
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Condition category
Condition code
Public Health
298403
298403
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0
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Health promotion/education
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Feasibility Testing of PrECEPt learning materials by carers
Carers supporting someone with nutrition/hydration and pain management issues will be invited to test PrECEPt, to determine proof of concept for this novel approach to carer education.
PrECEPt is an innovative distance learning package. The package uses blended learning to present two modules (pain, and nutrition/hydration). Written materials including information, reflections and hints/tips are combined with video vignettes which illustrate care-giving scenarios, offering practical illustrations of problems and potential solutions.
The package embeds three levels of information: basic, moderate and advanced. Caregivers decide themselves how much they wish to engage and at what level with the materials.
Carers will be mailed the package and, in the covering letter, encouraged to engage with the materials over a six week period. Data will be gathered on their engagement, to document dose, intensity and amount of engagement.
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Intervention code [1]
294385
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Other interventions
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Self-efficacy will be measured using the Ugalde tool (Ugalde et al. 2013). This is a 21 item, four factor, self-report questionniare which has been validated in cancer carers. The four factors are: resilience, self-maintenance, emotional connectivity and instrumental caregiving. Test-retest reliability and internal consistency were excellent (0.73-0.85, and 0.81-0.94 respectively).
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Assessment method [1]
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Timepoint [1]
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Baseline and immediately after intervention completion
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Secondary outcome [1]
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Cancer Caregiving Tasks, Consequences and Needs Questionnaire (CaTCoN). This is a 41 item scale to measure the extent of cancer caregiving tasks and consequences, and the caregivers' needs (mainly concerning information from and communication and contact with the health care professionals) (Lund et al. 2012).
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Assessment method [1]
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Timepoint [1]
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Baseline and immediately after intervention completion
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Secondary outcome [2]
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The Preparedness for Caregiving Scale (Archbold et al. 1990). This is an eight item questionnaire that assesses how ready caregivers perceive they are for their role. Reliability was acceptable with Cronbach’s alphas ranging from 0.86 to 0.92 (Archbold and Stewart 1993). Caregiver competence refers to the perceived adequacy of an individual’s performance as a caregiver.
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Assessment method [2]
322543
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Timepoint [2]
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Baseline and immediately after intervention completion
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Secondary outcome [3]
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A further bespoke questionnaire has been designed to capture core data on use and feedback on the educational materials.
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Assessment method [3]
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Timepoint [3]
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Baseline and immediately after intervention completion
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Secondary outcome [4]
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Post-intervention interviews will be conducted with key informant healthcare professionals (n = 4), and carers who completed the educational materials (n=16)
Interviews will elicit views on the acceptability and feasibility of the intervention; for example, eligibility criteria, method of recruitment, timing of offering the intervention in relation to the patient’s trajectory, duration of intervention. Four staff at the recruiting site will also be interviewed to gain feedback on recruitment processes, and the impact of the trial on interactions with the staff team (for example capturing information on whether more/different informational queries were received).
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Assessment method [4]
323580
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Timepoint [4]
323580
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Post-intervention
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Eligibility
Key inclusion criteria
Inclusion criteria for the carers taking part in the study:
(i) Recognised as the main carer for a patient receiving specialist palliative care
(ii) Supporting someone with nutrition/hydration and/or pain management needs
(iii) Aged over 18 years, and able to give informed consent
(iv) First language is English
(v) Patient’s life expectancy >12 weeks
(vi) Resident at home (not in residential aged care or receiving end-of-life care as an inpatient).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
We will exclude children and/or young people (i.e.<18) people who do not have the capacity to provide informed consent to take part in the research. Advice from the recruiting clinicians will be taken on individuals. We will also exclude people who do not have a good command of the English language, since this is a small proof of concept trial without resource to have the materials translated.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation concealment will not be used, as this is a single-group non-RCT design.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
This is not a randomised trial, consequently there is no sequence generation required.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Data from the primary and subsidiary outcome measures will be analysed using descriptive statistics. If adequate data is generated, then basic inferential statistics (t-tests) will be used to identify statistically significant changes in outcomes.
Analysis of the adherence checklist data will proceed using frequency counts to identify those areas addressed most and least frequently.
Qualitative interview data will be analysed thematically (Braun and Clarke 2006). Interviews will be digitally recorded, transcribed and managed using NVivo (version 10) software.
All data will be used to inform the refinement of the educational materials, and methodological parameters for a later scaled-up trial, including assessment of the feasibility and acceptability of the approach. Analysis of eligibility, and recruitment rates, will allow for national estimates to be calculated on number of potentially eligible carers across Australia.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2016
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Actual
1/08/2016
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Date of last participant enrolment
Anticipated
14/09/2016
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Actual
14/09/2016
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Date of last data collection
Anticipated
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Actual
31/10/2016
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Sample size
Target
22
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Accrual to date
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Final
23
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Recruitment in Australia
Recruitment state(s)
ACT
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Recruitment hospital [1]
5546
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Calvary Public Hospital ACT - Bruce
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Recruitment postcode(s) [1]
13021
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2600 - Barton
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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ACT Health
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Address [1]
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3, 11 Moore St, Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Australian Catholic University
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Address
223 Antill Street, Watson, Canberra, 2602, ACT.
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
292130
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Country [1]
292130
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294784
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Calvary Human Research Ethics Committee
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Ethics committee address [1]
294784
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Cnr Belconnen Way & Haydon Drive Bruce ACT 2617
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Ethics committee country [1]
294784
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Australia
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Date submitted for ethics approval [1]
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25/01/2016
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Approval date [1]
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10/03/2016
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Ethics approval number [1]
294784
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2-2016
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Summary
Brief summary
Families are viewed as a ‘unit of care’ in palliative services, meaning that carers’ needs are identified and addressed in order to further support the welfare of the patient. Practical educational interventions for carers are needed (Bee et al).; however it is not known which educational methods are acceptable and how high-quality information can be delivered at a national level, with limited cost implications. A significant gap in supporting carers is determining how high-quality relevant information can be delivered at a national level, with limited cost implications, using educational methods which are acceptable to carers. This study involves intervention development and an embedded proof of concept study. In this study we aim to: 1. Design an innovative distance-learning educational package (PrECEPt: PalliativE Carers Education Package). Two modules, identified as priorities in the literature (pain and nutrition/hydration), will be developed. 2. Determine ideal content, learning style preferences (e.g. balance of videos/ vignettes/ quizzes), mode of delivery (online/printed), level of detail/complexity. 3. Determine the acceptability and feasibility of the educational package to carer and healthcare professionals 4. To understand the processes involved in delivery of the key components of PrECEPt including: recruitment processes for a full-scale study; data collection procedures/completion rates; queries directed to the hospice from carers involved in the feasibility work. 5. Determine sample size, recruitment and randomisation processes for a definitive trial. We theorise that carer self-efficacy will increase through providing greater information, skills and confidence. We anticipate the education will benefit patients through more competent and supported carers. References Bee, P.E., Barnes, P. & Lucker, K. (2009) A systematic review of informal caregivers' needs in providing home-based end-of-life care to people with cancer. Journal of Clinical Nursing, 18(10), 1379-1393.
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Trial website
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Trial related presentations / publications
Forbat, L,. Haraldsdottir, E,. Lewis, M,. Hepburn, K. Supporting the provision of palliative care in the home environment: A proof of concept single arm trial of a palliative carers education package (PrECEPt). BMJ Open. http://bmjopen.bmj.com/content/6/10/e012681.short?g=w_open_current_tab
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Public notes
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Attachments [1]
1329
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/AnzctrAttachments/370466-BMJ Open_PrECEPt carer education protocol.pdf
(Protocol)
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Contacts
Principal investigator
Name
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Prof Liz Forbat
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Address
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Australian Catholic University
223 Antill St, Watson ACT 2602
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Country
64922
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Australia
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Phone
64922
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+61 475978476
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Fax
64922
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Email
64922
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[email protected]
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Contact person for public queries
Name
64923
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Liz Forbat
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Address
64923
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Australian Catholic University
223 Antill St, Watson ACT 2602
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Country
64923
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Australia
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Phone
64923
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+61 4 7597 8476
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Fax
64923
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Email
64923
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[email protected]
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Contact person for scientific queries
Name
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Liz Forbat
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Address
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Australian Catholic University
223 Antill St, Watson ACT 2602
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Country
64924
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Australia
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Phone
64924
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+61 4 7597 8476
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Fax
64924
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Supporting the provision of palliative care in the home environment: A proof-of-concept single-arm trial of a PalliativE Carers Education Package (PrECEPt).
2016
https://dx.doi.org/10.1136/bmjopen-2016-012681
N.B. These documents automatically identified may not have been verified by the study sponsor.
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