Multicenter Randomized Trial of Centralized Nurse-Led Telephone-Based Care Coordination to Improve Outcomes After Surgical Resection for Colorectal Cancer: The CONNECT Intervention

被引：81
作者：
Young, Jane M. [1 ]
Butow, Phyllis N. [1 ]
Walsh, Jennifer [1 ,2 ]
Durcinoska, Ivana [1 ,2 ]
Dobbins, Timothy A. [1 ]
Rodwell, Laura [1 ]
Harrison, James D. [1 ,2 ]
White, Kate [1 ]
Gilmore, Andrew [6 ]
Hodge, Bruce [7 ]
Hicks, Henry [8 ]
Smith, Stephen [8 ,9 ]
O'Connor, Geoff [10 ]
Byrne, Christopher M. [1 ,3 ]
Meagher, Alan P. [4 ]
Jancewicz, Stephen
Sutherland, Andrew [11 ]
Ctercteko, Grahame [5 ]
Pathma-Nathan, Nimalan [5 ]
Curtin, Austin [12 ]
Townend, David [12 ]
Abraham, Ned S. [11 ]
Longfield, Greg [7 ]
Rangiah, David [13 ]
Young, Christopher J. [1 ,3 ]
Eyers, Anthony [3 ]
Lee, Peter [3 ]
Fisher, Dean [10 ]
Solomon, Michael J. [1 ,2 ,3 ]
机构：
[1] Univ Sydney, Sydney, NSW 2006, Australia
[2] Sydney Local Hlth Dist, Surg Outcomes Res Ctr, Sydney, NSW, Australia
[3] Royal Prince Alfred Hosp, Sydney, NSW, Australia
[4] St Vincents Hosp, Sydney, NSW 2010, Australia
[5] Westmead Hosp, Sydney, NSW, Australia
[6] Orange Base Hosp, Orange, NSW, Australia
[7] Port Macquarie Base Hosp, Port Macquarie, NSW, Australia
[8] Wagga Wagga Base Hosp, Wagga Wagga, NSW, Australia
[9] John Hunter Hosp, Newcastle, NSW, Australia
[10] Dubbo Base Hosp, Dubbo, NSW, Australia
[11] Coffs Harbour Base Hosp, Coffs Harbour, NSW, Australia
[12] Lismore Base Hosp, Lismore, NSW, Australia
[13] Canberra Hosp, Canberra, ACT, Australia
来源：
JOURNAL OF CLINICAL ONCOLOGY | 2013年 / 31卷 / 28期
关键词：
SUPPORTIVE CARE; FUNCTIONAL ASSESSMENT; PILOT EVALUATION; NEEDS; PEOPLE; VALIDATION; INSTRUMENT;
D O I：
10.1200/JCO.2012.48.1036
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Purpose To investigate the effectiveness of a centralized, nurse-delivered telephone-based service to improve care coordination and patient-reported outcomes after surgery for colorectal cancer. Patients and Methods Patients with a newly diagnosed colorectal cancer were randomly assigned to the CONNECT intervention or usual care. Intervention-group patients received standardized calls from the centrally based nurse 3 and 10 days and 1, 3, and 6 months after discharge from hospital. Unmet supportive care needs, experience of care coordination, unplanned readmissions, emergency department presentations, distress, and quality of life (QOL) were assessed by questionnaire at 1, 3, and 6 months. Results Of 775 patients treated at 23 public and private hospitals in Australia, 387 were randomly assigned to the intervention group and 369 to the control group. There were no significant differences between groups in unmet supportive care needs, but these were consistently low in both groups at both follow-up time points. There were no differences between the groups in emergency department presentations (10.8% v 13.8%; P = .2) or unplanned hospital readmissions (8.6% v 10.5%; P = .4) at 1 month. By 6 months, 25.6% of intervention-group patients had reported an unplanned readmission compared with 27.9% of controls (P = .5). There were no significant differences in experience of care coordination, distress, or QOL between groups at any follow-up time point. Conclusion This trial failed to demonstrate substantial benefit of a centralized system to provide standardized, telephone follow-up for postoperative patients with colorectal cancer. Future interventions could investigate a more tailored approach.
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页码：3585 / +
页数：8
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