Leanne Monterosso1, Violet Platt2, Max Bulsara3, Melissa Berg4. 1. School of Nursing & Midwifery, University of Notre Dame Australia, PO Box 1225, Fremantle, Western Australia 6959, Australia; St John of God Murdoch Hospital, 100 Murdoch Dr, Murdoch, Western Australia 6150, Australia; School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Western Australia 6027, Australia; School of Health Professions, Murdoch University, 90 South Street, Murdoch, Western Australia 6150, Australia. Electronic address: leanne.monterosso@nd.edu.au. 2. School of Nursing & Midwifery, University of Notre Dame Australia, PO Box 1225, Fremantle, Western Australia 6959, Australia; School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Western Australia 6027, Australia; WA Cancer & Palliative Care Network, A Block, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, Western Australia 6009, Australia. Electronic address: Violet.Platt@health.wa.gov.au. 3. Institute for Health Research, University of Notre Dame Australia, PO Box 1225, Fremantle, Western Australia 6959, Australia; School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Australia; University College London, Gower St, Bloomsbury, London WC1E 6BT, United Kingdom. Electronic address: max.bulsara@nd.edu.au. 4. School of Nursing & Midwifery, University of Notre Dame Australia, PO Box 1225, Fremantle, Western Australia 6959, Australia. Electronic address: melissa.berg@nd.edu.au.
Abstract
PURPOSE: This systematic review aimed to determine the effectiveness of nurse-led cancer survivorship care, compared with existing models of care, on patient reported outcomes for cancer survivors. METHODS: Randomised and non-randomised controlled trials and controlled before-after studies published in English between 1 January 2007 and 28 July 2017 were identified in bibliographic databases including Medline, Pubmed and PsychINFO. Included studies described nurse-led cancer care after treatment to adults (age ≥18 years) <2 years post treatment completion. Risk of bias was assessed using Joanna Briggs Institute's tools and meta-analysis was undertaken. RESULTS: Twenty one publications were included describing 15 tumour-specific trials involving 3278 survivors of breast (n = 5), gynecological (n = 3), head and neck (n = 2), colorectal (n = 2), upper gastrointestinal (n = 2) and prostate (n = 1) cancers. Seven trials reported quality of life (QoL) using the EORTC QLQ-C30; participants receiving nurse-led care (4-6 months) had better cognitive (4 trials, 463 participants; mean difference [MD] = 4.04 [95% CI, 0.59-7.50]; p = 0.02) and social functioning (4 trials, 463 participants; MD = 3.06 [0.14-5.97]; p = 0.04) but worse appetite loss (3 trials, 354 participants; MD = 4.43 [0.08-8.78]; p = 0.05). After intervention completion, intervention participants had reduced fatigue (4 trials, 647 participants; MD = -4.45 [-7.93 to -0.97]; p = 0.01). CONCLUSION: This systematic review synthesised outcomes of models of nurse-led survivorship care and contributes a meta-analysis of patient QoL to survivorship evidence. This review was limited by the risk of bias in many included studies for blinding of treatment personnel and outcome assessors. Nurse-led care appears beneficial for cancer survivors for some QoL domains.
PURPOSE: This systematic review aimed to determine the effectiveness of nurse-led cancer survivorship care, compared with existing models of care, on patient reported outcomes for cancer survivors. METHODS: Randomised and non-randomised controlled trials and controlled before-after studies published in English between 1 January 2007 and 28 July 2017 were identified in bibliographic databases including Medline, Pubmed and PsychINFO. Included studies described nurse-led cancer care after treatment to adults (age ≥18 years) <2 years post treatment completion. Risk of bias was assessed using Joanna Briggs Institute's tools and meta-analysis was undertaken. RESULTS: Twenty one publications were included describing 15 tumour-specific trials involving 3278 survivors of breast (n = 5), gynecological (n = 3), head and neck (n = 2), colorectal (n = 2), upper gastrointestinal (n = 2) and prostate (n = 1) cancers. Seven trials reported quality of life (QoL) using the EORTC QLQ-C30; participants receiving nurse-led care (4-6 months) had better cognitive (4 trials, 463 participants; mean difference [MD] = 4.04 [95% CI, 0.59-7.50]; p = 0.02) and social functioning (4 trials, 463 participants; MD = 3.06 [0.14-5.97]; p = 0.04) but worse appetite loss (3 trials, 354 participants; MD = 4.43 [0.08-8.78]; p = 0.05). After intervention completion, intervention participants had reduced fatigue (4 trials, 647 participants; MD = -4.45 [-7.93 to -0.97]; p = 0.01). CONCLUSION: This systematic review synthesised outcomes of models of nurse-led survivorship care and contributes a meta-analysis of patient QoL to survivorship evidence. This review was limited by the risk of bias in many included studies for blinding of treatment personnel and outcome assessors. Nurse-led care appears beneficial for cancer survivors for some QoL domains.
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