Identifying, Understanding, and Overcoming Barriers to the Use of Clinical Practice Guidelines in Pediatric Oncology



Status:Recruiting
Conditions:Blood Cancer, Blood Cancer, Lymphoma, Lymphoma, Hematology, Hematology
Therapuetic Areas:Hematology, Oncology
Healthy:No
Age Range:Any - 20
Updated:1/25/2019
Start Date:November 21, 2016

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Use of Evidence-Based Supportive Care Clinical Practice Guidelines in Pediatric Oncology

This research trial studies the use of clinical practice guidelines by pediatric oncology
healthcare providers in order to identify, understand, and overcome barriers to them. The
treatments for childhood cancers are intense and result in a high rate of symptoms which
require support by healthcare providers. By reviewing patients' medical chart records,
meeting in focus groups and in one-on-one interviews, healthcare providers may improve how
clinical practice guidelines are used to support children undergoing cancer treatment.

PRIMARY OBJECTIVES:

I. To measure the rate of adherence to selected Children's Oncology Group (COG)-endorsed
supportive care clinical practice guidelines (CPG) recommendations at National Cancer
Institute (NCI) Community Oncology Research Program (NCORP) sites. (Aim 1) II. To describe
the possible influence of NCORP site size and the number of patients enrolled in COG studies
per site on the delivery of CPG-consistent care. (Aim 1a) III. To describe the clinical
outcome of episodes during which patients receive CPG-consistent or CPG-inconsistent care.
(Aim 1b) IV. To describe facilitators of and barriers to the use of CPGs elicited via focus
group interviews with a diverse set of potential users (physician, nurse, nurse practitioner
and pharmacists) who provide pediatric cancer care at NCORP sites. (Aim 2) V. To improve how
well CPG recommendations are understood by health care providers by refining the CPG
recommendation format based on an iterative process of cognitive interviewing and formatting
revisions. (Aim 3)

OUTLINE:

AIM 1 (CHART REVIEW): Patients are separated for each CPG evaluated (fever and neutropenia
[FN], chemotherapy induced nausea and vomiting [CINV], fertility preservation [FP]) and are
randomly selected for medical chart review. Patients with eligible episodes of FN, CINV or FP
within the health records are selected and have the data from their records abstracted and
reviewed by COG for adherence to COG endorsed CPGs.

AIM 2 (FOCUS GROUPS): Health care providers who provide direct care to pediatric oncology
patients are identified and separated to participate in three types of focus groups:
physician-only, non-physician, and mixed.

AIM 3 (INTERVIEWS): Health care providers undergo one-on-one interviews consisting of think
aloud technique (TAL) of cognitive interviewing.

Inclusion Criteria:

- Willingness to participate in all 3 aims

- AIM 1 - ELIGIBILITY CRITERIA FOR INCLUSION IN RETROSPECTIVE CENTRALIZED CHART REVIEW

- Received care as an inpatient or outpatient at a participating COG NCORP site during
the time period between January 1, 2014 and December 31, 2015

- Ever enrolled on any COG trial (episode does not have to occur while on trial and the
COG trial may be therapeutic or non-therapeutic)

- CPG-Specific Eligibility

- FN

- Has any of the following diagnoses:

- Newly diagnosed acute lymphoblastic leukemia

- Relapsed acute lymphoblastic leukemia

- Any acute myeloid leukemia

- Burkitt's or mature B cell non-Hodgkin's lymphoma

- Any myeloablative autologous or allogeneic hematopoietic stem cell
transplantation

- CINV

- Diagnosis of cancer

- Received moderately or highly emetogenic chemotherapy as an inpatient

- < 12 years of age at the start of a CINV episode and received highly emetogenic
chemotherapy as an in-patient

- FP

- Newly diagnosed cancer

- >= 15 years of age at cancer diagnosis

- Note: a single patient may contribute data for multiple episodes

- AIM 2 AND AIM 3 INCLUSION CRITERIA

- Healthcare professional currently employed at a participating COG NCORP institution

- Eligible healthcare providers include but are not limited to: physicians, nurses,
nurse practitioners, pharmacists, social workers, dieticians, psychologists, and
physical therapists/physiotherapists

- Provides direct care for children with cancer as part of current position at NCORP
site

Exclusion Criteria:

- AIM 2 AND AIM 3 EXCLUSION CRITERIA

- Trainees are excluded

- Previous participation in this study either for Aim 2 or Aim 3

- Each health care provider can only be involved in one event (focus group or interview)
We found this trial at
31
sites
1305 W 18th St
Sioux Falls, South Dakota 57117
(605) 333-1000
Principal Investigator: Kayelyn J. Wagner
Phone: 605-312-3320
Sanford USD Medical Center - Sioux Falls Sanford
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1201 Camino de Salud Northeast
Albuquerque, New Mexico 87131
(505) 272-4946
Principal Investigator: John F. Kuttesch
Phone: 505-925-0366
University of New Mexico Cancer Center It’s been 40 years since the New Mexico State...
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Albuquerque, NM
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4900 Mueller Boulevard
Austin, Texas 78723
(512) 324-0000
Principal Investigator: Amy C. Fowler
Dell Children's Medical Center of Central Texas Welcome to Dell Children
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Austin, TX
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3533 South Alameda Street
Corpus Christi, Texas 78411
(361) 694-5000
Principal Investigator: Nkechi I. Mba
Driscoll Children's Hospital Driscoll Children's Hospital was built because Clara Driscoll's will requested that a...
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Corpus Christi, TX
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1200 Pleasant Street
Des Moines, Iowa 50309
(515) 241-KIDS
Principal Investigator: Wendy L. Woods-Swafford
Phone: 515-241-6729
Blank Children's Hospital Blank Children's Hospital is completely dedicated to meeting the unique health care...
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Des Moines, IA
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100 Michigan Street Northeast
Grand Rapids, Michigan 49503
616.391.9000
Principal Investigator: Kathleen J. Yost
Phone: 616-391-1230
Helen DeVos Children's Hospital at Spectrum Health Helen DeVos Children's Hospital, located in Grand Rapids,...
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Grand Rapids, MI
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524 South Park Street
Kalamazoo, Michigan 49007
(269) 341-7654
Principal Investigator: Kathleen J. Yost
Phone: 616-391-1230
Bronson Methodist Hospital Our healthcare system serves patients and families throughout southwest Michigan and northern...
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Kalamazoo, MI
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1800 West Charleston Boulevard
Las Vegas, Nevada 89102
(702) 383-2000
Principal Investigator: Alan K. Ikeda
Phone: 702-384-0013
University Medical Center of Southern Nevada University Medical Center is dedicated to providing the highest...
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Las Vegas, NV
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5153 North 9th Avenue
Pensacola, Florida 32504
(850) 505-4700
Nemours Children's Clinic - Pensacola Nemours Children’s Clinic, Pensacola serves children and families in northwest...
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Pensacola, FL
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401 College Street
Richmond, Virginia 23298
(804) 828-0450
Principal Investigator: Gita V. Massey
Phone: 804-628-1939
Virginia Commonwealth University Massey Cancer Center Founded in 1974, VCU Massey Cancer Center is a...
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Richmond, VA
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4502 Medical Drive
San Antonio, Texas 78284
(210) 567-7000
Principal Investigator: Anne-Marie R. Langevin
Phone: 210-450-3800
University of Texas Health Science Center at San Antonio The University of Texas Health Science...
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7700 Floyd Curl Dr
San Antonio, Texas 78229
(210) 575-7000
Principal Investigator: Vinod K. Gidvani-Diaz
Methodist Children's Hospital of South Texas Methodist Children
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1 Tampa General Cir
Tampa, Florida 33606
(813) 844-7000
Principal Investigator: Juan F. Rico
Phone: 813-844-7829
Tampa General Hospital In a diverse city known for its rich culture and beautiful beaches,...
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Tampa, FL
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1600 Rockland Road
Wilmington, Delaware 19803
(302) 651-4200
Principal Investigator: Scott M. Bradfield
Phone: 302-651-6884
Alfred I. duPont Hospital for Children Nemours began more than 70 years ago with the...
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Wilmington, DE
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Bronx, New York 10467
Principal Investigator: Lisa Gennarini
Phone: 718-379-6866
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Bronx, NY
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801 Broadway North
Fargo, North Dakota 58122
Principal Investigator: Samuel O. Anim
Phone: 800-437-4010
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Fargo, ND
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Fort Myers, Florida 33908
Principal Investigator: Emad K. Salman
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Fort Myers, FL
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900 West Faris Rd.
Greenville, South Carolina 29605
(864)455-8898
Principal Investigator: Nichole L. Bryant
Phone: 864-241-6251
BI-LO Charities Children's Cancer Center The BI-LO Charities Children
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Greenville, SC
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Hollywood, Florida 33021
Principal Investigator: Iftikhar Hanif
Phone: 954-265-2234
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Hollywood, FL
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1319 Punahou St
Honolulu, Hawaii 96826
(808) 983-6000
Principal Investigator: Wade T. Kyono
Phone: 808-983-6090
Kapiolani Medical Center for Women and Children Hawai‘i Pacific Health is an integrated health care...
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Honolulu, HI
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Jacksonville, Florida 32207
Principal Investigator: Scott M. Bradfield
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Jacksonville, FL
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Las Vegas, Nevada 89144
Principal Investigator: Alan K. Ikeda
Phone: 702-384-0013
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Las Vegas, NV
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Las Vegas, Nevada 89135
Principal Investigator: Alan K. Ikeda
Phone: 702-384-0013
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New Orleans, Louisiana 70121
Principal Investigator: Craig Lotterman
Phone: 504-703-8712
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New Orleans, LA
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New Orleans, Louisiana 70118
Principal Investigator: Lolie C. Yu
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New York, New York 10032
Principal Investigator: Alice Lee
Phone: 212-305-6361
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New York, NY
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13535 Nemours Parkway
Orlando, Florida 32827
(407) 567-4000
Principal Investigator: Scott M. Bradfield
Nemours Children's Hospital Nemours Children's Hospital in Orlando brings pediatric specialty care never before offered...
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Saint Louis, Missouri 63141
Principal Investigator: Bethany G. Sleckman
Phone: 314-251-6770
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San Juan, 00912
Principal Investigator: Luis A. Clavell
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311 Martin Luther King Jr Way
Tacoma, Washington 98403
(253) 403-1400
Principal Investigator: Robert G. Irwin
Mary Bridge Children's Hospital and Health Center Mary Bridge Children's Hospital was established in 1955,...
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Tampa, Florida 33607
Principal Investigator: Mark J. Mogul
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