Jonathan Sussman1,2, Daryl Bainbridge1,3, Timothy J Whelan1,2, Kevin Brazil4,5, Sameer Parpia1,6, Jennifer Wiernikowski1,7, Susan Schiff1,3, Gary Rodin8,9, Myles Sergeant10,11, Doris Howell12,13. 1. Department of Oncology, McMaster University, Hamilton, ON, Canada. 2. Juravinski Cancer Centre, 699 Concession St. Rm 4-204, Hamilton, ON, L8V 5C2, Canada. 3. Juravinski Cancer Centre, 699 Concession St. Rm 4-214, Hamilton, ON, L8V 5C2, Canada. 4. School of Nursing and Midwifery, Queens University Belfast, Belfast, Ireland. 5. Medical Biology Centre, 97 Lisburn Road, Belfast, BT9 7BL, Ireland. 6. Juravinski Hospital and Cancer Centre, 711 Concession St. Section G, 1st Floor, Rm. 131, Hamilton, ON, L8V 1C3, Canada. 7. Juravinski Hospital and Cancer Centre, Unit C4, Room C4-59, 699 Concession St. Rm 4-204, Hamilton, ON, L8V 5C2, Canada. 8. Department of Supportive Care, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada. 9. 610 University Avenue Rm: Ste. 16-724, Toronto, ON, M5G 2M9, Canada. 10. Department of Family Medicine, McMaster University, Hamilton, ON, Canada. 11. St Peter's Hospital, 88 Maplewood Avenue, Hamilton, ON, L8M 1W9, Canada. 12. Faculty of Nursing, University of Toronto, Toronto, ON, Canada. doris.howell@uhn.on.ca. 13. University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada. doris.howell@uhn.on.ca.
Abstract
BACKGROUND: Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients. We conducted a randomized trial to test a community-based nurse-led coordination of care intervention in cancer patients. METHODS: Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services. Newly diagnosed breast and colorectal cancer patients within 7 days of cancer surgery were eligible. The primary outcome was the patient-reported outcome (PRO) of continuity of care (CCCQ) measured at 3 weeks. Secondary outcomes included unmet supportive care needs (SCNS), quality of life (EORTC QLQ-C30), health resource utilization, and level of uncertainty with care trajectory (MUIS) at 3 and/or 8 weeks. RESULTS:A total of 121 breast and 72 colorectal patients were randomized through 28 surgical practices. There was a small improvement in the informational domain of continuity of care (difference 0.29 p = 0.05) and a trend to less emergency room use (15.8 vs 7.1%) (p = 0.07). There were no significant differences between groups on unmet need, quality of life, or uncertainty. CONCLUSION: We did not find substantial gaps in the PROs measured immediately following surgery for breast and colorectal cancer patients. The results of this study support a more targeted approach based on need and inform future research focused on improving navigation during the initial phases of cancer treatment. ClinicalTrials.gov Identifier: NCT00182234. SONICS-Effectiveness of Specialist Oncology Nursing.
RCT Entities:
BACKGROUND: Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients. We conducted a randomized trial to test a community-based nurse-led coordination of care intervention in cancerpatients. METHODS: Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services. Newly diagnosed breast and colorectal cancerpatients within 7 days of cancer surgery were eligible. The primary outcome was the patient-reported outcome (PRO) of continuity of care (CCCQ) measured at 3 weeks. Secondary outcomes included unmet supportive care needs (SCNS), quality of life (EORTC QLQ-C30), health resource utilization, and level of uncertainty with care trajectory (MUIS) at 3 and/or 8 weeks. RESULTS: A total of 121 breast and 72 colorectalpatients were randomized through 28 surgical practices. There was a small improvement in the informational domain of continuity of care (difference 0.29 p = 0.05) and a trend to less emergency room use (15.8 vs 7.1%) (p = 0.07). There were no significant differences between groups on unmet need, quality of life, or uncertainty. CONCLUSION: We did not find substantial gaps in the PROs measured immediately following surgery for breast and colorectal cancerpatients. The results of this study support a more targeted approach based on need and inform future research focused on improving navigation during the initial phases of cancer treatment. ClinicalTrials.gov Identifier: NCT00182234. SONICS-Effectiveness of Specialist Oncology Nursing.
Entities:
Keywords:
Cancer care; Coordination; Nursing; Supportive care needs
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