Abstract
BackgroundColorectal cancer (CRC) is the most common cancer affecting both men and women in Australia. The illness and related treatments can cause distressing adverse effects, impact on emotional and psychological well-being, and adversely affect social, occupational and relationship functioning for many years after the end of treatment or, in fact, lifelong. Current models of follow-up fail to address the complex needs arising after treatment completion. Strategies to better prepare and support survivors are urgently required. We previously developed a nurse-led supportive care program (SurvivorCare) and tested it in a pilot study involving 10 CRC survivors. The intervention was found to be highly acceptable, appropriate, relevant and useful.Methods/designThis study is a multisite, randomised controlled trial, designed to assess the impact of the addition of the SurvivorCare intervention to usual post-treatment care, for people with potentially cured CRC. SurvivorCare comprises the provision of survivorship educational materials, a tailored survivorship care plan, an individually tailored nurse-led, face-to-face end of treatment consultation and three subsequent telephone calls. Eligible patients have completed treatment for potentially cured CRC. Other eligibility criteria include stage I to III disease, age greater than 18 years and adequate understanding of English. All consenting patients complete questionnaires at three time points over a six-month period (baseline, two and six months). Measures assess psychological distress, unmet needs and quality of life.DiscussionThis supportive care package has the potential to significantly reduce individual suffering, whilst reducing the burden of follow-up on acute cancer services through enhanced engagement with and utilisation of general practitioners and community based services. If the intervention is successful in achieving the expected health benefits, it could be disseminated readily. All training and supporting materials have been developed and standardised. Furthermore, the intervention could easily be adapted to other cancer or chronic disease settings.Trial registrationAustralian New Zealand Clinical Trial Registry ACTRN12610000207011.
Highlights
Colorectal cancer (CRC) is the most common cancer affecting both men and women in Australia
Study aim This study seeks to examine the effectiveness of an innovative supportive care program (SurvivorCare) comprising survivorship educational materials, provision of a tailored Survivorship care plan (SCP), an individually tailored nurse-led end of treatment consultation and telephone follow-up for people with potentially cured colorectal cancer, aiming to reduce psychological distress and unmet needs in the six months following treatment completion
The purpose of the sessions are to: a) support the patient during the post treatment completion period to reduce feelings of isolation or abandonment from the hospital team; (b) revisit needs discussed during the end of treatment session and explore in detail and respond to any concerns not addressed at that session; (c) screen for psychosocial distress and additional unmet needs using the Distress Thermometer, issues highlighted in the Question Prompt List (QPL) and the Survivor Care Plan; (d) encourage adherence to recommended self-care strategies and planned health behaviour change goals, and (e) emphasise the collaborative relationship between the patient’s GP and hospital team, highlighting that the patient’s GP has been provided with relevant information to enable effective shared care
Summary
CRC survivors represent a large and rapidly growing group of people. It is critical that their serious and often distressing needs following treatment completion are appropriately managed. There are few interventional studies that seek to improve psychosocial and supportive care outcomes for cancer survivors and the investigators identified no studies for patients with CRC, following treatment completion. This study will examine the impact of a nurse-led intervention package for CRC survivors using important clinical outcomes, such as distress, anxiety and depression, as well as unmet needs and quality of life. The intervention is patient-centred, individually tailored and nurse-led with active GP engagement It screens for distress, provides evidence based information and coaching in self-care and stress reduction. Authors’ contributions MJ conceptualised and designed the study, and led the development of this paper He participated in the implementation of the protocol and provided health professional training. PS assisted in the development of the protocol, the study design and the refinement of study materials, and provided health professional training.
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