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Trial Title: Shared Care Thyroid Cancer Follow-up Utilizing Thyroid Cancer Assessment Reminder System (TCARS) Study - A Pilot Study.

NCT ID: NCT05510934

Condition: Low Risk Differentiated Thyroid Cancer

Conditions: Official terms:
Thyroid Neoplasms
Thyroid Diseases

Conditions: Keywords:
low risk DTC
Shared-care model
decentralized clinical trial (DCT)
DTC
Thyroid Cancer
Feasibility Study

Study type: Observational

Overall status: Recruiting

Study design:

Time perspective: Prospective

Intervention:

Intervention type: Behavioral
Intervention name: Shared-care model
Description: A Shared care follow-up strategy involving patients, PCPs and specialists that uses an automated reminder system (TCARS).
Arm group label: Shared-care Group

Summary: This study aims to assess the feasibility of a shared-care model for low-risk differentiated thyroid cancer (DTC) patients, primary care practitioners (PCPs) and the tertiary care center utilizing a digital health-based thyroid cancer assessment reminder system (TCARS) in Medable with an expedited referral to specialists for rapid assessment in case of a concern of recurrence.

Detailed description: Low risk differentiated thyroid cancer (DTC) is being increasingly diagnosed and although its overall survival is excellent, lifelong follow-up is needed due to the risk of ongoing health challenges and the cancer recurring. While it is not feasible to follow this growing number of patients in specialist centers due to limited resources, recent studies have suggested that simply discharging them to their PCP is not ideal because many PCPs do not feel confident in managing various aspects of DTC. More importantly, a large number of patients in Nova Scotia do not have regular access to PCPs and are thus followed by walk-in clinics or nurse practitioners.The optimal approach would therefore be, to establish a shared care follow-up model including participation from patients, primary care practitioners (PCPs) and specialists. In this study, the feasibility of a shared care follow-up strategy involving patients, PCPs and specialists that uses an automated reminder system will be tested. This strategy will be compared to standard specialist only follow-up. The study population comprises 60 low risk adult DTC patients who will be randomly allocated to either Shared-care or Control group on a 1:1 basis (30 patients each). The main objectives of this study is to: 1. Develop a digital health-based thyroid cancer assessment reminder system alerting patients and PCPs of patients' forthcoming appointment and guidelines. 2. Establish an expedited referral pathway to tertiary care for rapid assessment of patients discharged to PCPs in case of a risk of recurrence. 3. Identify the feasibility of the Shared-care model. 4. Compare the completion of the clinical assessments between Shared-care and Control Groups. 5. Compare patient and provider satisfaction and acceptability between Shared-care and Control Groups. 6. Compare PCP confidence in dealing with DTC before and after study completion.

Criteria for eligibility:

Study pop:
Control group = 30 patients, where 15 patients are from the Nova Scotia central zone, and 15 patients are from the Nova Scotia non-central zone. Shared-care group = 30 patients, where 15 patients are from the Nova Scotia central zone, and patients are from the Nova Scotia non-central zone .

Sampling method: Probability Sample
Criteria:
Inclusion Criteria: Adult (>18 years old) consenting patients being followed at the Halifax Interdisciplinary Thyroid Oncology Clinic (ITOC) meeting the following criteria: - AJCC stage 1 DTC with no radiological or biochemical evidence of thyroid cancer with undetectable high sensitivity serum thyroglobulin (hsTG <0.06 mcg/L*); - Anti-thyroglobulin antibody (anti-TG AB <20 IU/ml*); - Thyroid ultrasound scan [USS] negative for regional recurrence at least 24 months after most recent treatment; - AJCC stage 2 DTC with no radiological or biochemical evidence of cancer (undetectable hsTG and anti-TG AB and negative thyroid USS) at least 48 months after most recent treatment - Patient is comfortable with using the mobile or Medable application and has access to internet. Exclusion Criteria: Patient does not have a consented PCP.

Gender: All

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: No

Locations:

Facility:
Name: Nova Scotia Health

Address:
City: Halifax
Zip: B2Y 1A7
Country: Canada

Status: Recruiting

Contact:
Last name: Glenda McCarthy

Phone: (902) 473-4997
Email: glenda.mccarthy@nshealth.ca

Start date: September 30, 2022

Completion date: December 30, 2025

Lead sponsor:
Agency: Nova Scotia Health Authority
Agency class: Other

Source: Nova Scotia Health Authority

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT05510934

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