National Research Centre of Cancer Rehabilitation, Odense C, Denmark.
Acta Oncol. 2011 Feb;50(2):299-306. doi: 10.3109/0284186X.2010.533193.
The effect of interventions that support rehabilitation among cancer patients has to be tested before implementation.
A randomised controlled trial was conducted to test the hypothesis that a multimodal intervention may give the general practitioner (GP) an enhanced role and improve rehabilitation for cancer patients. The intervention included an interview about rehabilitation needs with a rehabilitation coordinator (RC), information from the hospital to the general practitioner about individual needs for rehabilitation and an incentive for the GP to contact the patient about rehabilitation. The objective of this first report from the study was to examine the acceptability and feasibility of the intervention.
Adult patients treated for incident cancer at Vejle Hospital, Denmark were included between May 12, 2008 and February 28, 2009. All general practices in Denmark were randomised. Patients were allocated to intervention or control (usual procedures) based on the randomisation status of their GP. The feasibility of the intervention was analysed with regard to recruitment of patients, acceptability by patients and GPs and the degree to which the planned contacts between patients, RCs and GPs were implemented. The primary outcome of the randomised controlled trial (RCT) will be health-related quality of life at six months (EORTC-30).
Following assessment of 1 896 cancer patients, 955 patients (50%) registered with 323 general practices were included. The interview was conducted at the hospital with 50% of the patients in the intervention group, 31% were contacted by phone. Patients valued the fact that the conversation was dedicated to needs beyond the medical treatment. The GPs were generally available for information by phone and positive towards having a central role in the cancer rehabilitation.
It was feasible to conduct a RCT to evaluate a complex intervention in the healthcare system. All elements of the intervention were acceptable and feasible and may be implemented in future practice if the effect is positive.
在实施干预措施以支持癌症患者康复之前，必须对其效果进行测试。
本研究采用随机对照试验，旨在检验一种多模式干预措施是否能使全科医生（GP）发挥更大作用，并改善癌症患者的康复情况。该干预措施包括由康复协调员（RC）对康复需求进行访谈、向 GP 提供有关患者个人康复需求的医院信息，以及对 GP 进行激励，鼓励其与患者进行康复相关的联系。该研究的首次报告旨在评估该干预措施的可行性和可接受性。
丹麦 Vejle 医院收治的成年癌症患者于 2008 年 5 月 12 日至 2009 年 2 月 28 日期间纳入研究。丹麦所有的全科诊所均参与随机分组。根据 GP 的随机分组情况，将患者分为干预组或对照组（常规程序）。采用患者和 GP 的接受程度、患者与 RC 和 GP 之间计划联系的实施程度来评估干预措施的可行性。该随机对照试验（RCT）的主要结局指标为 6 个月时的健康相关生活质量（EORTC-30）。
在对 1896 例癌症患者进行评估后，纳入了 955 例（50%）患者，他们登记于 323 家全科诊所。在干预组的 50%患者中，于医院进行了访谈，31%通过电话进行了联系。患者对这种专门针对医疗治疗以外需求的对话表示满意。GP 通常可通过电话获取信息，并对在癌症康复中发挥核心作用持积极态度。
本研究采用 RCT 评估医疗系统中复杂干预措施的可行性，结果显示，该 RCT 可行性良好。所有干预措施均具有可接受性和可行性，如果效果为阳性，可在未来实践中实施。
