Abstract
Abstract
Purpose
The aim of this randomised controlled trial (RCT) was to explore whether a community nursing intervention for outpatients receiving systemic therapy reduced unplanned hospital presentations and improved physical and psychosocial health outcomes over the first three cycles of treatment compared to a control group receiving standard care.
Methods
The number of and reasons for unplanned presentations were obtained for 170 intervention and 176 control group adult patients with solid tumours starting outpatient chemotherapy. Poisson regression was used to compare the number of presentations between the intervention and control groups. Patients self-completed the Hospital Anxiety and Depression Scale, the Cancer Behavior Inventory and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) at the start of the first four cycles. Linear regression techniques were used to compare quality of life outcomes.
Results
The reduction in unplanned presentations in the intervention group relative to the control group was 12% (95% CI, − 25%, 37%; P = 0.48). At the start of cycle 4, there was no difference in anxiety (difference = 0.47 (95% CI, − 0.28, 1.22; P = 0.22)), depression (difference = 0.57 (95% CI, − 0.18, 1.31; P = 0.13)) or EORTC QLQ-C30 summary score (difference = 0.16 (95% CI, − 2.67, 3.00; P = 0.91)). Scores for self-efficacy as measured by the Cancer Behavior Inventory were higher in the intervention group (difference = 4.3 (95% CI, 0.7, 7.9; P = 0.02)).
Conclusion
This RCT did not demonstrate a benefit in reducing unplanned presentations to hospital. The trial identified improved cancer-based self-efficacy in patients receiving the intervention.
Trial registration
Registered at Australian and New Zealand Clinical Trials Registry: ACTRN12614001113640, registered 21/10/2014.
Funder
National Health and Medical Research Council
University of Sydney
Publisher
Springer Science and Business Media LLC
Reference47 articles.
1. Kristensen SR, Bech M, Quentin W (2015) A roadmap for comparing readmission policies with application to Denmark, England, Germany and the United States. Health Policy 119(3):264–273
2. Department of Health. Keeping Australians Out of Hospital. 2019; Available from: https://www.health.gov.au/initiatives-and-programs/keeping-australians-out-of-hospital. Accessed 28 September 2020
3. Council of Australian Governments (2018) Heads of Agreement between the Commonwealth and the States and Territories on public hospital funding and health reform. 2018: Australia. https://federation.gov.au/about/agreements/heads-agreement-between-commonwealth-and-states-and-territories-public-hospital. Accessed 28 September 2020
4. McKenzie H et al (2011) Chemotherapy outpatients’ unplanned presentations to hospital: a retrospective study. Support Care Cancer 19(7):963–969. https://doi.org/10.1007/s00520-010-0913-y
5. National Cancer Control Indicators. Systemic anti-cancer therapy treatment activity. (2017) https://ncci.canceraustralia.gov.au/treatment/systemic-anti-cancer-therapy-treatment-activity/systemic-anti-cancer-therapy-treatment. Accessed 6th April 2020
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献