Grant Number:	1R01CA101704-01 Interpret this number
Primary Investigator:	Ahles, Tim
Organization:	Dartmouth College
Project Title:	Improving Palliative Care for Patients with Cancer
Fiscal Year:	2003

DESCRIPTION: (Provided by applicant) The recent report of the Institute of Medicine concludes that there is a critical need for research designed to improve care at the end of life. Project ENABLE, a Robert Wood Johnson funded demonstration project designed to improve end-of-life care in cancer patients, showed that a palliative care model that focused on early intervention (at the time of diagnosis of advanced cancer), patient education, preference- based treatment and coordinated care is: 1) feasible to implement in a comprehensive cancer center; 2) accepted by oncologists who are focused on aggressive/clinical trials- oriented care; and 3) accepted and valued by patients and family members. This application is designed to refine the ENABLE intervention and increase its efficiency by integrating approaches developed by the Dartmouth Northern New England Cooperative Research Group that have focused on practice system changes that improve quality and efficiency of care. The primary goal of this application is to test the efficacy of an intervention for improving palliative care for cancer patients that includes: 1) the Dartmouth Clinical Improvement System which emphasizes rapid assessment of problems and feedback to patients (including tailored educational materials) and practitioners; 2) telephone- base nurse educators who will provide ongoing symptom and problem assessment, coordination of care between the cancer center health care team and other services, and education regarding problem-solving, communication with the healthcare team, advanced care planning and symptom management; and 3) Drop-In Group Medical Appointments (DIGMAs) for symptom management. Patients with advanced lung, gastrointestinal, and breast cancer seen at the Norris Cotton Cancer Center will be identified at diagnosis and randomized to receive the ENABLE II intervention or standard care. The primary hypotheses are: 1) Patients randomized to the ENABLE II intervention will report better symptom management, higher quality of life, a better match between preferences and the care received, and lower health care utilization as compared to patients in the standard care group and 2) Family members of patients receiving the ENABLE II intervention will report better quality of care, symptom management, and match between preferences and care received as measured by the After Death Interview.




Dispositional hope as a potential outcome parameter among patients with advanced malignancy: An analysis of the ENABLE database.
Authors: Corn B.W. , Feldman D.B. , Hull J.G. , O'Rourke M.A. , Bakitas M.A. .
Source: Cancer, 2021-10-06 00:00:00.0; , .
EPub date: 2021-10-06 00:00:00.0.
PMID: 34613617
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A semiparametric joint model for terminal trend of quality of life and survival in palliative care research.
Authors: Li Z. , Frost H.R. , Tosteson T.D. , Zhao L. , Liu L. , Lyons K. , Chen H. , Cole B. , Currow D. , Bakitas M. .
Source: Statistics In Medicine, 2017-12-20 00:00:00.0; 36(29), p. 4692-4704.
EPub date: 2017-08-17 00:00:00.0.
PMID: 28833347
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On the Road Less Traveled: Journey of an Oncology Palliative Care Researcher.
Authors: Bakitas M.A. .
Source: Oncology Nursing Forum, 2017-01-01 00:00:00.0; 44(1), p. 87-95.
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Family Caregiver Depressive Symptom and Grief Outcomes From the ENABLE III Randomized Controlled Trial.
Authors: Dionne-Odom J.N. , Azuero A. , Lyons K.D. , Hull J.G. , Prescott A.T. , Tosteson T. , Frost J. , Dragnev K.H. , Bakitas M.A. .
Source: Journal Of Pain And Symptom Management, 2016 Sep; 52(3), p. 378-85.
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Oncologists' perspectives on concurrent palliative care in a National Cancer Institute-designated comprehensive cancer center.
Authors: Bakitas M. , Lyons K.D. , Hegel M.T. , Ahles T. .
Source: Palliative & Supportive Care, 2013 Oct; 11(5), p. 415-23.
PMID: 23040412
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Patient perspectives on participation in the ENABLE II randomized controlled trial of a concurrent oncology palliative care intervention: benefits and burdens.
Authors: Maloney C. , Lyons K.D. , Li Z. , Hegel M. , Ahles T.A. , Bakitas M. .
Source: Palliative Medicine, 2013 Apr; 27(4), p. 375-83.
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Impact on caregiver burden of a patient-focused palliative care intervention for patients with advanced cancer.
Authors: O'Hara R.E. , Hull J.G. , Lyons K.D. , Bakitas M. , Hegel M.T. , Li Z. , Ahles T.A. .
Source: Palliative & Supportive Care, 2010 Dec; 8(4), p. 395-404.
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Authors: Bakitas M. , Bishop M.F. , Caron P. , Stephens L. .
Source: Seminars In Oncology Nursing, 2010 Nov; 26(4), p. 266-84.
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Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial.
Authors: Bakitas M. , Lyons K.D. , Hegel M.T. , Balan S. , Brokaw F.C. , Seville J. , Hull J.G. , Li Z. , Tosteson T.D. , Byock I.R. , et al. .
Source: Jama, 2009-08-19 00:00:00.0; 302(7), p. 741-9.
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The project ENABLE II randomized controlled trial to improve palliative care for rural patients with advanced cancer: baseline findings, methodological challenges, and solutions.
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Source: Palliative & Supportive Care, 2009 Mar; 7(1), p. 75-86.
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Reliability and validity of the Functional Assessment of Chronic Illness Therapy-Palliative care (FACIT-Pal) scale.
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Source: Journal Of Pain And Symptom Management, 2009 Jan; 37(1), p. 23-32.
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Proxy perspectives regarding end-of-life care for persons with cancer.
Authors: Bakitas M. , Ahles T.A. , Skalla K. , Brokaw F.C. , Byock I. , Hanscom B. , Lyons K.D. , Hegel M.T. , ENABLE project team .
Source: Cancer, 2008-04-15 00:00:00.0; 112(8), p. 1854-61.
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Palliative care program effectiveness research: developing rigor in sampling design, conduct, and reporting.
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Occupation as a vehicle to surmount the psychosocial challenges of cancer.
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