Prospective study of specialist oncology community nursing resulting in improvements in key patient supportive care outcomes

Abstract

9107 Background: Cancer patients report ongoing significant gaps in supportive care. To date few interventions have been shown to improve supportive care outcomes in cancer. Research in other areas suggests that specialist nursing interventions in the community may address gaps in unmet need, continuity of care and quality of life. This study prospectively studied a community based nursing intervention for cancer patients. Methods: Patients were followed using a longitudinal cohort design, with assessments at baseline (T1), four (T2) and eight (T3) weeks, upon enrollment in a specialist nursing program. The nursing intervention included a comprehensive supportive care assessment and subsequent care delivery or linkage to appropriate services in the community. Validated patient assessment outcomes included: Supportive Cancer Needs Survey Short Form 34, Quality of Life (EORTC QLC-30(v3)), Continuity and Coordination of Care (CCCQ), and a service utilization instrument. Results: 72 of 109 enrolled patients completed all study measures. The majority had advanced stage disease. Median age was 59 years. Disease categories for participants included: breast (33%), gastrointestinal. (18.1%), lung (13.9%), ovarian (9.7%), and head and neck (8.3%). All participants received a baseline comprehensive assessment and had a mean of 1.7 home visits with a mean of 3.9 telephone contacts. We observed significant reductions in most supportive care need domains ( Table ). There were trends to improvement in domains of quality of life and continuity of care. We also observed reductions in acute care services use and increased community agency use. Conclusions: This is one of the first prospective studies in cancer patients that demonstrates improvements in a number of supportive care outcomes through a community based specialist nursing intervention. A randomized study to confirm these findings is currently underway. [Table: see text] No significant financial relationships to disclose.