Advancing Care Coordination Between Cancer and Primary Care Teams for Complex Cancer Survivors

Launched by RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY · Feb 18, 2025

Keywords

ClinConnect Summary

This clinical trial is studying a new way to help cancer survivors who also have other health issues, like high blood pressure or diabetes. The goal is to see if a special program called Primary Care Connect (PC2) can help these patients manage their heart health better than those who receive standard care. Participants in the PC2 group will have more support from both their cancer care team and their primary care doctors throughout their cancer treatment. The study will also look at how well this care model works from the perspective of both healthcare teams and patients.

To be eligible for this trial, participants need to have been diagnosed with certain types of cancers, such as breast, prostate, bladder, or endometrial cancer, in the past six months. They should also have at least one health condition that puts them at risk for heart problems, like high blood pressure or diabetes. Those who join the study will receive information about what to expect, complete surveys at four different times, and visit the clinic for check-ups and tests four times over the course of the study. This trial is not yet recruiting participants, and it is important to note that individuals who have had serious heart issues recently or have advanced kidney disease are not eligible.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • diagnosed with any of the following cancers \[Stage I-III\]: breast, prostate, urinary bladder, and endometrial in the past 6 months;
• • being treated for cancer with curative intent;
• • had initial patient visit at the cancer center in the last 3 months;
• • are being treated for cancer with curative intent at the Rutgers Cancer Institute of New Jersey
• • have ≥1 CVD risk factor (hypertension, hyperlipidemia or type II diabetes) prior to cancer diagnosis that requires medication management;
• • currently receiving care from a primary care provider or willing to initiate seeing a new primary care provider upon enrollment;
• • Speak English or Spanish
• Exclusion Criteria:
• • had myocardial infarction or stroke within the previous 1 year; (2) have heart failure with an ejection fraction \<30%; (3) have stage IV-V chronic kidney disease (eGFR \<30); or do not speak English or Spanish. Patients whose cancer progresses to metastatic disease during the course of the 18-month trial will be allowed to continue to participate unless they voluntarily withdraw