Abstract
IntroductionPatients suffering from cancer are often managed by multiple health professionals. General practitioners with specific skills in oncology could facilitate care coordination between hospital and general practice in the management of these patients. To explore this hypothesis, we run a randomised clinical trial, called ‘Concertation de REtour à DOmicile, CREDO’. The main objective is to explore the effectiveness of a ‘return home’ consultation compared with standard care. The number of unscheduled visits to care centres is used to evaluate the effectiveness of the treatment.Methods and analysisCREDO is a multicentre, randomised, open-label, prospective trial. It takes place in two specialised cancer care centres in southern France (Occitania region). Patient inclusion criteria are: be over 18 years old; be treated with a first cycle of metastatic chemotherapy in a specialised cancer care centre; have a metastatic solid cancer and be returning home after treatment. Patients are randomised in two arms: standard-arm (conventional management) or intervention-arm (CREDO management). In the intervention arm, a ‘return home’ consultation is carried out in three steps. First, the investigating GP (GP with specific skills in oncology) from the specialised care centre collects information about the patient and patient’s management choices. Then, the investigating GP conducts an interview with the patient’s referring GP to quickly communicate and discuss information about the patient. Finally, the investigating GP summarises these exchanges and transmits this information to the care centres chosen by the patient.All the patients are followed for 1 year.Statistical and medicoeconomic analysis are planned.Ethics and disseminationThis clinical trial is registered under ClinicalTrials.gov identifier and was approved by the ethics committee of South-Western French Committee for the Protection of Persons (number: 2016-A01587-44) and from the French National Drug Safety Agency (ANSM, number: 2016111500034).An international publication of the final results and conference presentations will be planned.Trial registration numberNCT02857400.
Funder
French Ministry of Health's Directorate-General for Healthcare Services
Reference13 articles.
1. McDonald KM , Sundaram V , Bravata DM , et al . Closing the quality gap: A critical analysis of quality improvement strategies (vol. 7: care coordination). Agency for Healthcare Research and Quality (US): Rockville (MD), 2007.
2. Care coordination measures of a family medicine residency as a model for hospital readmission reduction;Mathews;Am J Manag Care,2014
3. Guideline sheets on the side effects of anticancer drugs are useful for general practitioners;Rouge-Bugat;Support Care Cancer,2015
4. Gimenez L , Druel V , Roques S , et al . Inventory of tools for care coordination between general practice and hospital system for patients suffering from cancer in active phase of treatment: a scoping review. Eur J Cancer Care (Engl) 2020;29:e13319. doi:10.1111/ecc.13319
5. Bridging the gap between primary care and the cancer system: the UPCON network of cancercare manitoba;Sisler;Can Fam Physician,2009