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CTRI Number  CTRI/2022/02/039951 [Registered on: 02/02/2022] Trial Registered Prospectively
Last Modified On: 28/01/2022
Post Graduate Thesis  No 
Type of Trial  Observational 
Type of Study   Follow Up Study 
Study Design  Single Arm Study 
Public Title of Study   Effect of Project ECHO (Extension for Community Healthcare Outcomes) online lecture series to improve the quality of Palliative care services in lower middle income countries- Kenya, Nigeria, Ghana, South Africa, and India  
Scientific Title of Study   ECHO Telementoring to Improve Quality Palliative Care in Underserved Areas of Zambia, Kenya, Nigeria, Ghana, South Africa, and India. 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
NCT04984551  ClinicalTrials.gov 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Jayita Deodhar 
Designation  Professor 
Affiliation  Tata Memorial Centre 
Address  Room no 75,Main Building-Ground floor,Tata Memorial Centre,Earnest Borges Road,Parel, Mumbai.

Mumbai
MAHARASHTRA
400012
India 
Phone  24177000  
Fax    
Email  jukd2000@yahoo.co.uk  
 
Details of Contact Person
Scientific Query
 
Name  Jayita Deodhar 
Designation  Professor 
Affiliation  Tata Memorial Centre 
Address  Room No 75,Main Building-Ground floor,Tata Memorial Centre,Earnest Borges Road,Parel, Mumbai.

Mumbai
MAHARASHTRA
400012
India 
Phone  24177000  
Fax    
Email  jukd2000@yahoo.co.uk  
 
Details of Contact Person
Public Query
 
Name  Jayita Deodhar 
Designation  Professor 
Affiliation  Tata Memorial Centre 
Address  Room No 75-Main Building- Ground floor,Tata Memorial Centre,Earnest Borges Road,Parel, Mumbai.

Mumbai
MAHARASHTRA
400012
India 
Phone  24177000  
Fax    
Email  jukd2000@yahoo.co.uk  
 
Source of Monetary or Material Support  
M D Anderson Cancer Centre 
 
Primary Sponsor  
Name  M D Anderson Cancer Centre 
Address  1515 Holcombe Blvd, Houston, Texas,77030, United States 
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     Ghana
India
Nigeria
South Africa
Zambia
Kenya  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Jayita Deodhar  Tata Memorial Centre , Mumbai   Palliative Care OPD-Room number 75(Main Building), Ground floor Tata Memorial Centre, Parel. Mumbai 400012
Mumbai
MAHARASHTRA 
24177000

jukd2000@yahoo.co.uk 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institution Ethics Comitee-TMC Mumbai  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: C00-D49||Neoplasms,  
 
Intervention / Comparator Agent  
Type  Name  Details 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  99.00 Year(s)
Gender  Both 
Details  Patient:
1) Scheduled to receive treatment at participating primary care practice for advanced cancer.
2) 18 years or older
3) Willing to be accessible to the research team for follow-up by telephone or in person
4)Prognosis of at least 1 year as ascertained by the treating physician
5)Able to read and understand English as assessed by the treating physician.

Caregiver:
1)Identified or self-identified as primary caregiver of the patient
2) Willing to be accessible to the research team for follow-up by telephone or in person
3) 18 years or older
4) Able to read and understand English as assessed by the treating physician.

ECHO Participant:
1) Participant must be a health care provider interested to participate in the study for 2 years and understand the protocol and provide consent.
2) Able to read and understand English as assessed by PI  
 
ExclusionCriteria 
Details  1) Unable to understand and sign consent. 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
To evaluate the effects of Project ECHO on patient-reported quality of life [QOL] (as assessed by the change in Functional Assessment of Cancer Illness Therapy FACT-G) in seriously ill patients of providers receiving ECHO Model-Based comprehensive educational and telementoring intervention (ECHO-Palliative Care, or ECHO-PCT).   0 months, 4 months, 8 months, 12 months, 16 months, 20 months, 24months  
 
Secondary Outcome  
Outcome  TimePoints 
1. To examine the effects of ECHO-PCT on patients’ symptom distress as well as patient and caregiver experience and satisfaction.
2. To explore the effects of ECHO-PCT on providers’ efficacy in, knowledge of, and competence to deliver Palliative Care to Patients with serious life limiting illness, as well as their satisfaction with providing Palliative Care services ; (ii) increase patient access to quality palliative care in these regions (morphine consumption); and (iii) increase in the number of palliative care procedures performed by the ECHO participants (subcutaneous hydration, opioid rotation). iv) increased patient access to PC measured by the number of patient visits (new and follow-ups); v) provider turnover; vi) adherence, measured by the number of ECHO sessions held, the number of ECHO participants at each session, and the number of cases reviewed; and vii) comfort with the ECHO platform and ability to learn/engage via distance technology,  
0 months, 4 months, 8 months, 12 months, 16 months, 20 months, 24months  
 
Target Sample Size   Total Sample Size="150"
Sample Size from India="50" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   10/02/2022 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  24/08/2020 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="2"
Months="2"
Days="20" 
Recruitment Status of Trial (Global)   Open to Recruitment 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   Yes-Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care Yennurajalingam et al Jounal of Global Oncology 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

Patients with advanced  cancer suffer from devastating symptoms due to the disease and its treatment which impacts their quality of life and overall survival. In patients receiving  palliative  treatment,the intensity and severity of symptoms increase ,and they have increased financial and spiritual concerns and functional decline. The countries like Zambia, Kenya, Nigeria, Ghana, South Africa, and India remain ill-equipped to take care of the palliative care needs of cancer patients in advanced stages.To assist with training physicians, nurses, volunteers helping the patients with life limiting illnesses with skills required to provision of quality palliative care, we are proposing a collaborative project using Project ECHO.

The primary objective is to evaluate the effects of Project ECHO on patient-reported quality of life [QOL] in seriously ill patients of providers receiving ECHO Model-Based comprehensive educational and telementoring intervention .The secondary objective is to  examine the effects of tele mentoring on patients’ symptom distress ,and to explore the effects on providers’ efficacy in, knowledge of, and competence to deliver Palliative Care to Patients with serious life limiting illness, as well as their satisfaction with providing Palliative Care services.

The two provider centers/organizations for Tata Memorial Hospital(TMH) in India are- Department of Palliative Care in HBCH and MPMMMC, Varanasi and Department of Palliative Medicine TMH Mumbai, in collaboration with Palcare India, Mumbai (patient will be recruited in TMH only).

We will be recruiting 50 patients in each center and they will be followed up every 4 months till a period of 2 years. This is a prospective observational study. All project data will be collected using REDCap (Research Electronic Data Capture) electronic data capture tools hosted at MD Anderson (http://www.project-redcap.org). The data will be summarized by descriptive statistics at baseline, year 1 and 2 of ECHO-PCT.

Through constant engagement, this project will enrich the research collaborations and educational partnerships between MD Anderson and our Sister Institution Network colleagues in Lower Middle Income Countries

 
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