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

Young, Jane; Butow, Phyllis; Walsh, Jennifer; Durcinoska, Ivana; Dobbins, Timothy; Rodwell, Laura; Harrison, James D.; White, Kathryn; Gilmore, Andrew; Hodge, Bruce E.; Hicks, Henry; Smith, Stephen R.; O'Connor, Geoff; Byrne, Christopher; Meagher, Alan P.; Jancewicz, Stephen; Sutherland, Andrew; Ctercteko, Grahame; Pathma‐Nathan, Nimalan; Curtin, Austin; Townend, David; Abraham, Ned; Longfield, Greg; Rangiah, David; Young, Christopher J.; Eyers, A. A.; Lee, Peter; Fisher, D.; Solomon, Michael J.

doi:10.1200/jco.2012.48.1036

Cited by 96 publications

(131 citation statements)

References 18 publications

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“…Eight trials evaluated educational or supportive care interventions [35–42]. Other tested interventions included relaxation (e.g., progressive muscle relaxation [PMR]; n = 2) [43,44], written and verbal emotional expression ( n = 1) [33], an Eastern Body-Mind-Spirit intervention ( n = 1) [45], intimacy enhancement ( n = 1) [34], and a self-efficacy enhancing intervention ( n = 1) [46].…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of psychosocial interventions for colorectal cancer patients

Mosher

Winger

Given

et al. 2017

Support Care Cancer

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Purpose A significant minority of colorectal cancer (CRC) patients experience clinically meaningful distress that may warrant intervention. The goal of this systematic review was to assess the impact of psychosocial interventions on quality-of-life and psychosocial outcomes for CRC patients. Methods A systematic search of CINAHL, MEDLINE, PsycINFO, and PsycARTICLES was undertaken to obtain relevant randomized controlled trials (RCTs) published through October 2016. Results Fourteen RCTs of psychosocial interventions for CRC patients were identified. Only three of these RCTs showed significant intervention effects on multiple mental health outcomes. These interventions included written and verbal emotional expression, progressive muscle relaxation training, and a self-efficacy enhancing intervention. Eight of the 14 trials, testing a range of psychoeducational and supportive care interventions, produced little to no effects on study outcomes. An evaluation of RCT quality highlighted the need for greater rigor in study methods and reporting. Conclusion A limited evidence base supports the efficacy of psychosocial interventions for CRC patients. Large-scale trials are needed before drawing definitive conclusions regarding intervention impact.

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Section: Resultsmentioning

confidence: 99%

“…Six of the trials produced null effects of the intervention across all outcome variables [35–38,42,44]. These trials tested diverse interventions, including psychoeducation, supportive care, patient navigation, and training in relaxation and other coping skills.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of psychosocial interventions for colorectal cancer patients

Mosher

Winger

Given

et al. 2017

Support Care Cancer

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“…The evidence was inconclusive regarding which patients have the most unmet needs, 10,11 or whether screening for unmet needs may improve patient-reported outcomes. 13,30 The findings of the current study support that telephone-based nursing care is appropriate and acceptable, [10][11][12]15 yet the optimal dose intensity or timing for all patients remain elusive. 31 Although the current intervention did not affect patient-reported outcomes, the entire sample demonstrated patterns of change, which can inform future work.…”

Section: Discussionmentioning

confidence: 66%

“…[10][11][12][13][14][15][16] Outpatient oncology involves a complex system of medical, nursing, and other providers. 15 Prior intervention effects possibly might be enhanced by having patients' own providers deliver visits for managing symptoms, prescribing medications, and titrating doses. Therefore, the current study expanded on prior interventions by testing a model designed to reduce patient-reported symptom burden and to be delivered by each patient's oncology team nurse practitioner (NP).…”

Section: Introductionmentioning

confidence: 99%

Nursing intervention to enhance outpatient chemotherapy symptom management: Patient‐reported outcomes of a randomized controlled trial

Traeger

McDonnell

McCarty

et al. 2015

Cancer

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BACKGROUND:The authors conducted a randomized controlled trial to evaluate a nurse practitioner (NP)-delivered symptom management intervention for patients initiating chemotherapy for nonmetastatic cancer. The aim was to reduce patient-reported symptom burden by facilitating patient-NP collaboration and the early management of symptoms. METHODS: At the time of the first chemotherapy visit, adult participants with nonmetastatic breast, colorectal, or lung cancer (120 participants) completed self-report measures and were then randomly assigned to standard care plus the intervention or standard care alone. Intervention participants received proactive telephone calls from their oncology team NP during the week after each of the first 2 chemotherapy administration visits. Measures were repeated at the second and third chemotherapy visits. Group differences were analyzed with regard to patient-reported symptoms (Memorial Symptom Assessment Scale-Short Form items), satisfaction with care (Family Caregiver Satisfaction-patient scale), and the likelihood of depression or anxiety symptoms (Patient Health Questionnaire-4). RESULTS: At the time of the first visit, 50.8% of participants reported 1 physical symptom, most commonly lack of energy (35.8%) and drowsiness (30.8%). The number of symptoms (gamma coefficient [g] 5 0.16; P<.001), symptom distress (g 5 0.45; P<.001), and satisfaction with care (g 5 0.24; P 5 .004) increased whereas the likelihood of anxiety symptoms decreased (g 5 -0.19; P 5 .02) and the likelihood of depression symptoms did not change (g 5 0.01; P 5 .91). Outcomes did not differ by randomized group. Randomized group interacted with emetogenic potential in predicting symptom distress (c 5 0.43; P 5 .03) and satisfaction with care (c 5 -0.45; P 5 .045). CONCLUSIONS: The intervention did not appear to reduce symptom burden compared with standard care. Early symptoms highlight the importance of continuing to examine strategies to improve symptom management during chemotherapy for nonmetastatic disease. Cancer 2015;121:3905-13.

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“…This is in line with findings from previous work. 2 Four cases of symptomatic intra-cerebral recurrence were identified prior to protocol change. Only one of these patients was eligible for radio-surgery.…”

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confidence: 99%

P162 CT follow up after surgery for lung cancer – should the availability of radio-surgery prompt a change in screening protocol to detect early intracerebral recurrence?

Roberts

Jones

Exley

2015

Thorax

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Although routinely performed, the optimal screening regimen for recurrent disease after curative surgery for lung cancer has yet to be agreed. Radio-surgery has improved prognosis for patients with limited intra-cerebral metastases,1 however screening for intracerebral recurrence has little evidence base. Local protocol is to perform CT head/chest/abdomen pre surgery and CT chest/abdomen at 3, 12 and 24 months after surgery. We proposed that the addition of CT head to the post-surgical protocol would enable earlier detection of intra-cerebral recurrence, facilitating timely treatment.CT head was added to standard post surgical surveillance programme in February 2015. CT reports were reviewed prospectively and we report data to June 2015. For comparison, retrospective data for all patients currently enrolled in screening was also reviewed.All 222 CT scans for the 115 patients undergoing post-surgical surveillance were reviewed. 28 of these have been performed since our protocol changed to include CT head.In total, 22 patients (19%) had recurrent disease. 2 patients had isolated intracerebral recurrence. This represents 9% of all patients with recurrent disease and these patients would not be identified on previous screening protocol. This is in line with findings from previous work.2Four cases of symptomatic intra-cerebral recurrence were identified prior to protocol change. Only one of these patients was eligible for radio-surgery. Since protocol change, one case of asymptomatic isolated intra-cerebral recurrence has been detected through screening; this patient was thereafter treated with radio-surgery.Our results show that isolated intra-cerebral recurrence would be missed on the previous screening protocol. These preliminary results suggest that the addition of CT head in post operative surveillance enables earlier identification of these patients. The earlier detection of intracerebral recurrence as a result of screening may increase referrals for radio-surgery, with potential for improved survival.Abstract P162 Figure 1 References1 Andrews, et al. Lancet 2004;363:16652 Yokoi, et al. Ann Thorac Surg. 1996;61:546

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

Abstract: 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.

Cited by 96 publications

References 18 publications

A systematic review of psychosocial interventions for colorectal cancer patients

A systematic review of psychosocial interventions for colorectal cancer patients

Nursing intervention to enhance outpatient chemotherapy symptom management: Patient‐reported outcomes of a randomized controlled trial

P162 CT follow up after surgery for lung cancer – should the availability of radio-surgery prompt a change in screening protocol to detect early intracerebral recurrence?

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