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The aim of this study is to develop and identify the most effective strategy to implement PCRPs into daily care. We want to assess the added value of a multi-faceted strategy compared with a single-faceted patient-directed strategy.
The aim of this study is to develop and identify the most effective strategy to implement PCRPs into daily care. We want to assess the added value of a multi-faceted strategy compared with a single-faceted patient-directed strategy.
We will conduct a clustered controlled before and after study (CBA) in the Netherlands that compares two strategies to implement PCRPs. The patient-directed (PD) strategy (five hospitals) will focus on change at the patient level. The multi-faceted (MF) strategy (five hospitals) will focus on change at the patient, professional and organizational levels. Eligibility criteria are as follows: (A) patients: adults; preferably (history of) cancer in the gastro-intestinal, reproductive and/or urological system; successful primary treatment; and without recurrence/metastases. (B) Healthcare professionals: involved in cancer care.
A stepwise approach will be followed:
Step 1: Analysis of the current implementation of PCRPs and the examination of barriers and facilitators for implementation, via a qualitative study with patients (four focus groups n = 10-12) and their healthcare workers (four focus groups n = 10-12 and individual interviews n = 30-40) and collecting data on adherence to quality indicators (n = 500 patients, 50 per hospital).
Step 2: Selection and development of interventions to create a PD and MF strategy during expert's roundtable discussions, using the knowledge gained in step 1 and a literature search of the effect of strategies for implementing PCRPs.
Step 3: Test and compare both strategies with a clustered CBA (effectiveness, process evaluation and costs), by data extraction from existing registration systems, questionnaires and interviews. For the effectiveness and cost-effectiveness, n = 500 patients, 50 per hospital. For the process evaluation, n=50 patients, 5 per hospital, and n = 40 healthcare professionals, 4 per hospital.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| The patient-directed (PD) strategy | Other | A single-faceted patient-directed (PD) strategy that will embed the change at patient level. |
|
| The multi-faceted (MF) strategy | Other | A multi-faceted (MF) strategy that will embed the change at the patient, professional and organizational levels. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The patient-directed (PD) strategy | Other | The patient-directed strategy will be designed to embed the success of implementation of PCRPs by influencing the patients. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The percentage of screened patients with the screening tool recommended by the Dutch guideline 'Cancer Rehabilitation'. | A pre- and post measurement of 'the percentage of screened patients with the screening tool recommended by the Dutch guideline 'Cancer Rehabilitation'' will be done. The differences between the pre- and post measurement will be measured. | baseline and at follow-up |
| The percentage of referrals to PCRPs where needed, according to the Dutch guideline 'Cancer Rehabilitation'. | A pre- and post measurement of 'The percentage of referrals to PCRPs where needed, according to the Dutch guideline 'Cancer Rehabilitation'' will be done. The differences between the pre- and post measurement will be measured. | baseline and at follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of life | A pre- and post measurement of 'QoL' will be done. The differences between the pre- and post measurement will be measured. | baseline and at follow-up |
| Patientempowerment | A pre- and post measurement of 'patientempowerment' will be done. The differences between the pre- and post measurement will be measured. |
| Measure | Description | Time Frame |
|---|---|---|
| Process-evaluation | The experiences and exposure of patients and professionals with the PD- and MF strategy will be evaluated by interviews. | at follow-up |
| Cost | incremental costs and incremental cost-effectiveness ratios (ICERs) |
Inclusion Criteria:
patients:
Healthcare professionals:
• involved in cancer care in one of the participating hospitals
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| C. IJsbrandy, MD | Contact | +31 (0)24 3615305 | charlotte.ijsbrandy@radboudumc.nl | |
| R.P.M.G. Hermens, PhD | Contact | +31 (0)24 3615305 | Rosella.hermens@radboudumc.nl |
| Name | Affiliation | Role |
|---|---|---|
| C. IJsbrandy, MD | Radboud Univeristy Medical Centre Nijmegen | Principal Investigator |
| R.P.M.G. Hermens, PhD | Radboud Univeristy Medical Centre Nijmegen | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Radboud University Nijmegen Medical Center | Recruiting | Nijmegen | Gelderland | 6500HB | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26345182 | Derived | IJsbrandy C, Ottevanger PB, Groen WG, Gerritsen WR, van Harten WH, Hermens RP. Study protocol: an evaluation of the effectiveness, experiences and costs of a patient-directed strategy compared with a multi-faceted strategy to implement physical cancer rehabilitation programmes for cancer survivors in a European healthcare system; a controlled before and after study. Implement Sci. 2015 Sep 7;10:128. doi: 10.1186/s13012-015-0312-3. |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D005221 | Fatigue |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |
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| The multi-faceted (MF) strategy | Other | The multi-faceted strategy will be designed to embed the success by not only influencing the patients, but also professionals and organizational aspects. |
|
| baseline and at follow-up |
| Remaining quality indicators of the Dutch guideline 'Cancer Rehabilitation'. | A pre- and post measurement of ' the Remaining quality indicators of the Dutch guideline 'Cancer Rehabilitation'' will be done. The differences between the pre- and post measurement will be measured. | baseline and at follow-up |
| at follow-up |