Gervès-Pinquié Chloé, Daumas-Yatim Fatima, Lalloué Benoît, Girault Anne, Ferrua Marie, Fourcade Aude, Lemare François, Dipalma Mario, Minvielle Etienne
Equipe d'Accueil Management des Organisations de Santé, Ecole des Hautes Etudes en Santé Publique, Avenue du Professeur Léon-Bernard, 35043, Rennes, France.
Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France.
BMC Health Serv Res. 2017 Feb 13;17(1):133. doi: 10.1186/s12913-017-2066-x.
The emergence of oral delivery in cancer therapeutics is expected to result in an increased need for better coordination between all treatment stakeholders, mainly to ensure adequate treatment delivery to the patient. There is significant interest in the nurse navigation program's potential to improve transitions of care by improving communication between treatment stakeholders and by providing personalized organizational assistance to patients. The use of health information technology is another strategy aimed at improving cancer care coordination that can be combined with the NN program to improve remote patient follow-up. However, the potential of these two strategies combined to improve oral treatment delivery is limited by a lack of rigorous evidence of actual impact.
METHODS/DESIGN: We are conducting a large scale randomized controlled trial designed to assess the impact of a navigation program denoted CAPRI that is based on two Nurse Navigators and a web portal ensuring coordination between community and hospital as well as between patients and navigators, versus routine delivery of oral anticancer therapy. The primary research aim is to assess the impact of the program on treatment delivery for patients with metastatic cancer, as measured by Relative Dose Intensity. The trial involves a number of other outcomes, including tumor response, survival, toxic side effects, patient quality of life and patient experience An economic evaluation adopting a societal perspective will be conducted, in order to estimate those health. care resources' used. A parallel process evaluation will be conducted to describe implementation of the intervention.
If the CAPRI program does improve treatment delivery, the evidence on its economic impact will offer important knowledge for health decision-makers, helping develop new follow-up services for patients receiving oral chemotherapy and/or targeted therapy. The process evaluation will determine the best conditions in which such a program might be implemented.
NCT 02828462 . Registered 29 June 2016.
癌症治疗中口服给药方式的出现,预计将导致所有治疗相关方之间更需要加强协调,主要是为了确保患者能得到充分的治疗。护士导航项目有潜力通过改善治疗相关方之间的沟通以及为患者提供个性化的组织协助来改善护理转接,这引发了人们极大的兴趣。使用健康信息技术是另一种旨在改善癌症护理协调的策略,可与护士导航项目相结合以改善远程患者随访。然而,这两种策略结合起来改善口服治疗给药的潜力因缺乏实际影响的严格证据而受到限制。
方法/设计:我们正在进行一项大规模随机对照试验,旨在评估一个名为CAPRI的导航项目的影响,该项目基于两名护士导航员和一个网络门户,可确保社区与医院之间以及患者与导航员之间的协调,与口服抗癌治疗的常规给药方式进行对比。主要研究目的是评估该项目对转移性癌症患者治疗给药的影响,以相对剂量强度来衡量。该试验还涉及许多其他结果,包括肿瘤反应、生存率、毒副作用、患者生活质量和患者体验。将从社会角度进行经济评估,以估计所使用的医疗保健资源。将进行并行的过程评估以描述干预措施的实施情况。
如果CAPRI项目确实能改善治疗给药,其经济影响的证据将为卫生决策者提供重要知识,有助于为接受口服化疗和/或靶向治疗的患者开发新的随访服务。过程评估将确定实施此类项目的最佳条件。
NCT 02828462。于2016年6月29日注册。