Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery: a cluster randomized trial
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.
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.
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.
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.
KeywordsCancer care Coordination Nursing Supportive care needs
The authors gratefully acknowledge funding received for this study from the Ministry of Health and Long Term Care, Toronto, Ontario.
JS, DH, TW, KB, JW, and GR designed the study. DB and SS enrolled the surgeons and patients, and gathered data. SP and DB did the statistical analysis. DB, JS, DH, and TW interpreted the data and drafted the manuscript. All authors reviewed, edited, and approved the manuscript before submission.
Compliance with ethical standards
To conduct the study was obtained from the hospitals from which surgeons recruited patients.
Conflict of interest
The authors declare that they have no conflict of interest.
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