Evidence map›Paper›PMID 38287335›Full record

ArticleBMC palliative care2024

ENABLE-SG (Educate, Nurture, Advise, Before Life Ends for Singapore) as a proactive palliative care model: protocol for a hybrid type 1 effectiveness-implementation randomized wait-list controlled trial.

Yu Ke, Yin Bun Cheung, Marie Bakitas, J Nicholas Odom, Elaine Lum, Daniel Shao Weng Tan, Tira J Tan, Eric Finkelstein, Hong Choon Oh, Siqin Zhou and 1 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in BMC palliative care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06044441 (ENABLE-SG), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06044441 narecruitingnot on this map

ENABLE-SG (Educate, Nurture, Advise, Before Life Ends for Singapore) as a Proactive Palliative Care Model: Evaluation and Implementation Preparation

TypeinterventionalSponsorNational Cancer Centre, SingaporeRan2023 to 2027Enrolled715ConditionsNeoplasmsArmsENABLE-SG model, Wait-list control
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yu KeDivision of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
Yin Bun CheungCentre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.
Marie BakitasSchool of Nursing, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
J Nicholas OdomSchool of Nursing, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
Elaine LumDuke-NUS Medical School, Program in Health Services & Systems Research, Singapore, Singapore.
Daniel Shao Weng TanDivision of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
Tira J TanDivision of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
Eric FinkelsteinDuke-NUS Medical School, Program in Health Services & Systems Research, Singapore, Singapore.
Hong Choon OhDuke-NUS Medical School, Program in Health Services & Systems Research, Singapore, Singapore.
Siqin ZhouDivision of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore, Singapore.
Grace Meijuan YangDivision of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore. grace.yang.m.j@singhealth.com.sg.

Funding

National Medical Research Council (Singapore) HCSAINV23jan-0001
6 · The paper itself

Abstract

backgroundSpecialist palliative care is often provided late in the patient's disease trajectory in response to uncontrolled symptoms. Shifting from this reactionary illness-stress paradigm to a proactive health-wellness approach, the ENABLE (Educate, Nurture, Advise, Before Life Ends) telehealth model aims to enhance the coping, stress and symptom management, self-care, and advance care planning skills of patients with advanced cancers and their caregivers. The ENABLE model has been culturally adapted to Singapore (ENABLE-SG) and pilot-tested. A hybrid type 1 effectiveness-implementation design will be used to evaluate the effectiveness of ENABLE-SG while collecting real-world implementation data.

methodsThis single-centre, assessor-blind, wait-list (immediately vs. 6 months) randomized controlled trial will recruit 300 adult patients within 60 days of an advanced cancer diagnosis and their family caregivers from the National Cancer Centre of Singapore. ENABLE-SG comprises structured psychoeducational sessions with a telehealth coach, covering essential topics of early palliative care. Participants will be assessed at baseline and every 3 months until patient's death, 12 months (caregivers), or end of study (patients). The primary outcome is patient quality of life 6 months after baseline. Secondary patient-reported outcomes include mood, coping, palliative care concerns, and health status. Secondary caregiver-reported outcomes include caregiver quality of life, mood, coping, and care satisfaction. Mixed-effects regression modelling for repeated measurements will be used. To assess the effectiveness of ENABLE-SG versus usual care, patient and caregiver outcomes at 6 months will be compared. To compare earlier versus delayed ENABLE-SG, patient and caregiver outcomes at 12 months will be compared. Within the hybrid type 1 effectiveness-implementation design, implementation outcomes will be evaluated in both the early and delayed groups. Acceptability, adoption, appropriateness, and feasibility will be assessed using a feedback survey and semi-structured interviews with a purposive sample of patients, caregivers, and healthcare providers. Transcribed interviews will be analysed thematically. Other implementation outcomes of penetration, fidelity, and cost will be assessed using records of study-related processes and summarized using descriptive statistics. A cost-effectiveness analysis will also be conducted. DISCUSSION: This study will assess both effectiveness and implementation of ENABLE-SG. Insights into implementation processes can facilitate model expansion and upscaling.

trial registrationRegistered prospectively on ClinicalTrials.gov, NCT06044441. Registered on 21/09/2023.

Indexed as

Hospice and Palliative Care NursingNeoplasmsTerminal CareAdultCaregiversHumansPalliative CareQuality of LifeRandomized Controlled Trials as TopicSingaporeCancerHealth coachingImplementationPalliative carePsychoeducationalTelehealth

Identifiers

PMID38287335
PMCPMC10826230

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.