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跨专业基于证据的癌症患者补充和整合医疗保健咨询方案:对照实施研究 CCC-Integrativ 的研究方案。

Interprofessional evidence-based counselling programme for complementary and integrative healthcare in patients with cancer: study protocol for the controlled implementation study CCC-Integrativ.

机构信息

Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany

Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.

出版信息

BMJ Open. 2022 Feb 11;12(2):e055076. doi: 10.1136/bmjopen-2021-055076.


DOI:10.1136/bmjopen-2021-055076
PMID:35149568
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8845169/
Abstract

INTRODUCTION: According to international literature, patients with cancer wish to have information on complementary and integrative healthcare (CIH). Medical guidelines recommend actively approaching patients with cancer discussing potential benefits and risks of individual CIH methods. While some CIH methods, for example, acupuncture and yoga, have been proven effective in high-quality studies, other CIH methods lack studies or bear the risk of interactions with chemotherapeutics, for example, herbal drugs. Therefore, an evidence-based interprofessional counselling programme on CIH will be implemented at four Comprehensive Cancer Centres in the federal state of Baden-Wuerttemberg, Germany. METHODS AND ANALYSIS: A complex intervention consisting of elements on patient, provider and system levels will be developed and evaluated within a multilayer evaluation design with confirmatory evaluation on patient level. Patients with a cancer diagnosis within the last 6 months will receive three individual counselling sessions on CIH within 3 months (=intervention on patient level). The counselling will be provided by an interprofessional team of medical and nursing staff. For this purpose, an intensive online training programme, a CIH knowledge database and an interprofessional team-building process were developed and implemented (=intervention on provider level). Moreover, training events on the basics of CIH are offered in the outpatient setting (=intervention on system level). Primary outcome of the evaluation at the patient level is patient activation measured (PAM) with the PAM-13 after 3 months. Secondary outcomes, for example, quality of life, self-efficacy and clinical parameters, will be assessed at baseline, after 3 months and at 6 months follow-up. The intervention group (n=1000) will be compared with a control group (n=500, treatment as usual, no CIH counselling. The outcomes and follow-up times in the control group are the same as in the intervention group. Moreover, the use of health services will be analysed in both groups using routine data. A qualitative-quantitative process evaluation as well as a health economic evaluation will identify relevant barriers and enabling factors for later roll-out. ETHICS AND DISSEMINATION: The study has been approved by the appropriate Institutional Ethical Committee of the University of Tuebingen, No. 658/2019BO1. The results of these studies will be disseminated to academic audiences and in the community. TRIAL REGISTRATION NUMBER: DRKS00021779; Pre-results.

摘要

简介:根据国际文献,癌症患者希望获得有关补充和整合医疗保健(CIH)的信息。医学指南建议积极与癌症患者接触,讨论个别 CIH 方法的潜在益处和风险。虽然一些 CIH 方法,例如针灸和瑜伽,在高质量的研究中已被证明有效,但其他 CIH 方法缺乏研究或存在与化疗相互作用的风险,例如草药。因此,德国巴登-符腾堡州的四个综合癌症中心将实施一项关于 CIH 的循证跨专业咨询计划。

方法和分析:将开发一种复杂的干预措施,包括患者、提供者和系统层面的元素,并在具有确认性评估的多层评估设计中进行评估。在过去 6 个月内被诊断患有癌症的患者将在 3 个月内接受三次关于 CIH 的个体咨询(=患者层面的干预)。咨询将由医疗和护理人员的跨专业团队提供。为此,开发并实施了一个密集的在线培训计划、一个 CIH 知识库和一个跨专业团队建设过程(=提供者层面的干预)。此外,还在门诊环境中提供关于 CIH 基础知识的培训活动(=系统层面的干预)。评估的主要结果是在 3 个月后使用 PAM-13 测量患者激活度(PAM)。次要结果,例如生活质量、自我效能和临床参数,将在基线、3 个月和 6 个月随访时进行评估。干预组(n=1000)将与对照组(n=500,常规治疗,无 CIH 咨询)进行比较。对照组的结局和随访时间与干预组相同。此外,还将使用常规数据分析两组的卫生服务使用情况。定性定量的过程评估和健康经济评估将确定后续推出的相关障碍和促成因素。

伦理和传播:该研究已获得图宾根大学适当机构伦理委员会的批准,编号为 658/2019BO1。这些研究的结果将向学术受众和社区传播。

注册号:DRKS00021779;预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/9e9213dc5947/bmjopen-2021-055076f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/aed9cdcc5da2/bmjopen-2021-055076f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/0ce1dfbe6387/bmjopen-2021-055076f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/9c5dc8f2fe0c/bmjopen-2021-055076f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/9e9213dc5947/bmjopen-2021-055076f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/aed9cdcc5da2/bmjopen-2021-055076f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/0ce1dfbe6387/bmjopen-2021-055076f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/9c5dc8f2fe0c/bmjopen-2021-055076f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/8845169/9e9213dc5947/bmjopen-2021-055076f04.jpg

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