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Trial registered on ANZCTR
Registration number
ACTRN12623000192684
Ethics application status
Approved
Date submitted
3/02/2023
Date registered
23/02/2023
Date last updated
23/02/2023
Date data sharing statement initially provided
23/02/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Identification and Multidisciplinary Prehabilitation of at Risk Elderly patients undergoing colorectal cancer therapy (IMPRovE). A feasibility scoping study to implement a prehabilitation programme at Western Health
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Scientific title
Identification and Multidisciplinary Prehabilitation of at Risk Elderly patients undergoing colorectal cancer therapy (IMPRovE). A feasibility scoping study to implement a prehabilitation programme at Western Health
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Secondary ID [1]
308902
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Nil Known
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Universal Trial Number (UTN)
U1111-1287-9127
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Trial acronym
IMPRovE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
colorectal cancer
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frailty
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older age
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Condition category
Condition code
Cancer
325891
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0
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Bowel - Back passage (rectum) or large bowel (colon)
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Physical Medicine / Rehabilitation
325954
325954
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0
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Physiotherapy
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Physical Medicine / Rehabilitation
325955
325955
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0
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Occupational therapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients equal or over the age of 65 will have a frailty assessment using the G8 scoring system.
Patients who score 14 or below will have a comprehensive geriatric assessment by a geriatrician. A multidisciplinary team (physiotherapy, dietetics) will assess these patients and a prescribed pre habilitation programme will be designed and offered to the patient to complete over a period of 4 weeks. These interventions will be individualised based on clinical assessment. Dietician may prescribe dietary supplementation; physiotherapists may prescribe daily exercise regime and geriatricians may optimise patient drug therapy. However, it will be 1x1 hour consultation per fortnight for 4 weeks as a one on one face to face consultation by both a dietician and physiotherapist. Adherence monitoring will include food diary and exercise diary. Following this programme, patients will then proceed to their planned colorectal cancer surgery. Patients will have a 2 week and 90 day post surgery interview.
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Intervention code [1]
325403
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Treatment: Other
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Comparator / control treatment
There is no control. This is a feasibility trial.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Measures of feasibility (composite outcome):-
Evaluation of the acceptability and suitability of the intervention and preliminary evaluation of participant responses to intervention using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and the Feasibility of Intervention Measurement (FIM)
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Assessment method [1]
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Timepoint [1]
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At enrolment and week 4 (after enrolment) just prior to surgery
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Primary outcome [2]
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Rate of adherence to the intervention protocol - eg using daily food plan, exercise diary
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Assessment method [2]
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Timepoint [2]
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At the time of prehabilitation assessment, review of food plan and exercise diary will be completed
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Primary outcome [3]
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Time to geriatrician and prehabilitation team review by audit of study database
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Assessment method [3]
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Timepoint [3]
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At the time of completion of assessments (prehabilitation and geriatrician), review of study database will be performed to gather information on time from recruitment to time to complete assessments
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Secondary outcome [1]
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Surgical complications (Clavien-Dindo classification) from medical records
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Assessment method [1]
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Timepoint [1]
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30 day post operation
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Secondary outcome [2]
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post operative mortality from medical records
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Assessment method [2]
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Timepoint [2]
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30 day and 90 day post operation
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Secondary outcome [3]
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Geriatric (composite)
Need for sub-acute care, delay to surgery, change to alternative care pathway (i.e.: non-surgical resection), delirium incidence, pressure injury, falls incidence in hospital. From hospital records
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Assessment method [3]
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Timepoint [3]
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30 day post surgery
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Secondary outcome [4]
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Patient-Reported Outcome Measures (PROMs), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Colorectal Cancer Module (EORTC QLQ-CR 29) and Quality of Life of Cancer Patients scale (EORTC QLQ-C30).
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Assessment method [4]
418354
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Timepoint [4]
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30 and 90 days after surgery. Patient questionnaire
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Secondary outcome [5]
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Nutrition:-
Weight loss (weigh scale), Patient generated subjective global assessment (PGSGA), pre-albumin (blood test), and hand grip strength with a dynamometer. These will be a composite assessment of the patients total nutritional status rather than multiple outcomes.
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Assessment method [5]
418355
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Timepoint [5]
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30 days and 90 days post surgery
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Eligibility
Key inclusion criteria
• Aged over 65
• Scoring 14 or less on the G8 screening tool for frailty
• Planned curative intent surgery for primary Colorectal cancer at Western Health
• English speaking and literate
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Minimum age
65
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?
No
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Key exclusion criteria
Patients who present as an emergency to Western Health
Patients who have metastatic disease
Patients who lack the capacity to provide informed consent
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Study design
Purpose of the study
Prevention
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/04/2023
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Actual
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Date of last participant enrolment
Anticipated
22/12/2023
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Actual
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Date of last data collection
Anticipated
1/04/2024
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Western Health, Melbourne
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Address [1]
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Footscray Hospital, 160 Gordon Street, Footscray VIC 3011
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Western Health, Melbourne
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Address
Footscray Hospital, 160 Gordon Street, Footscray VIC 3011
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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]
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Country [1]
314810
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Melbourne Health
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Ethics committee address [1]
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Level 2 South West 300 Grattan Street Parkville Victoria 3050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
312360
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Approval date [1]
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22/11/2022
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Ethics approval number [1]
312360
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Summary
Brief summary
Currently, frailty is rarely identified prior to surgery and patients undergoing colorectal cancer surgery do not have prehabilitation optimization at Western Health (WH). Recent investigations of our WH population have identified poorer functional outcomes and lower quality of life associated with this population which indicated unmet psychosocial and occupational performance needs. With this study, we plan to introduce a novel approach to tailored treatment in our most at-risk group of patients. Who is it for? You may be eligible for this study if you are an adult who has a planned surgery for primary colorectal cancer at Western Health. Study details All patients enrolled in this study will undergo a frailty assessment and be prescribed a pre habilitation to be completed over a period of 4 weeks. This prehabilitation program will include nutritional adjustment by a dietician and improvement of exercise function by physiotherapy. Patient quality of life questionnaires, food diary, nutritional and physical fitness assessment will be carried out by dieticians and physiotherapists. It is hoped that this study will show that it is feasible for frail and at-risk colorectal cancer patients undergoing surgery to undergo prehabilitation. This aims to improve strength, mobility and flexibility, reduce frailty, and improve post-operational outcomes such as length of stay.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Justin Yeung
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Address
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Level 3, Department of Surgery, WCHRE building, Sunshine Hospital, Furlong Road, St Albans VIC 3021
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Country
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Australia
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Phone
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+61 383958116
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Justin Yeung
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Address
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Level 3, Department of Surgery, WCHRE building, Sunshine Hospital, Furlong Road, St Albans VIC 3021
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Country
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Australia
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Phone
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+61 383958116
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Justin Yeung
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Address
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Level 3, Department of Surgery, WCHRE building, Sunshine Hospital, Furlong Road, St Albans VIC 3021
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Country
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Australia
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Phone
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+61 383958116
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Fax
124380
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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
No additional documents have been identified.
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