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| ID | Type | Description | Link |
|---|---|---|---|
| R392-A23403 | Other Grant/Funding Number | Danish Cancer Society |
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FRAME is a patient-centered survivorship care model embedded in routine oncology visits. It consists of: (1) a pre-visit patient-reported questionnaire (FRAME-PRO), (2) a clinician-patient dialogue guided by the responses, and (3) a tailored management plan including stepped-care referrals (general practitioner and municipality; oncology department supportive services; specialized late-effects clinics). The implementation is evaluated with the RE-AIM framework supplemented by Proctor implementation outcomes. Data sources include the "Mit Sygehus" app, departmental registries, purpose-built questionnaires, fidelity checklists, and qualitative interviews with clinicians, patients, and informal caregivers.
The project implements FRAME at the Department of Oncology, Vejle Hospital. The FRAME-PRO enables patients and informal caregivers to reflect on late effects and needs before the visit. During the visit, clinicians access FRAME-PRO electronically to prioritize what matters most, assess severity (triage), and co-create a management plan documented in the electronic health record using a purpose-developed standard phrase to support cross-sector information transfer. Implementation strategies are informed by the Expert Recommendations for Implementing Change (ERIC) and local logs (education, audit & feedback, reminders, local champions, technical assistance). Evaluation follows RE-AIM: Reach (completion of FRAME-PRO), Effectiveness (referrals to supportive care, quality of life, time use), Adoption (clinician use), Implementation (fidelity to opening, discussing, and managing needs), and Maintenance (sustained use). Quantitative data are summarized descriptively; qualitative data are analyzed with content analysis. Ethics approval covers interviews with patients, caregivers, and clinicians.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single Arm - Department-wide implementation of FRAME | Other | FRAME model (questionnaire + dialogue + management plan) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FRAME model (questionnaire + dialogue + management plan) | Behavioral | Administration of the patient-developed FRAME-PRO prior to the visit; clinician-patient dialogue guided by responses; stepped-care management/referrals; documentation via standard EHR phrase. Implementation strategies include educational meetings/materials, ongoing training, audit & feedback at weekly huddles, reminders/prompts, local champions, and local technical assistance. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of oncologists who actively use FRAME in ≥50% of eligible outpatient visits. | Adoption | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of eligible outpatient visits with completed FRAME-PRO (via "Mit Sygehus"). | Reach | Continuously during implementation (up to 6 months) |
| Change in proportion of visits/patients with referrals to supportive care units compared with pre-implementation baseline. |
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Inclusion Criteria:
- All oncologists conducting outpatient visits at the Department of Oncology, Vejle Hospital during the study period.
Exclusion Criteria:
- None.
Participants for interviews:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Johanne D Lyhne, PhD | Contact | 004522910740 | JOHANNE.DAM.LYHNE@RSYD.DK | |
| Karin Larsen | Contact | Karin.Larsen1@rsyd.dk |
| Name | Affiliation | Role |
|---|---|---|
| Torben F Hansen, Dr. Med. | Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Denmark | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark | Recruiting | Vejle | Region Syddanmark | 7100 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40150842 | Background | Lyhne JD, Gade L, Hansen L, Johansen A, Smith A', Jensen LH, Ventzel L. Survivor-driven development of a PROM for use in routine colorectal cancer care. Acta Oncol. 2025 Mar 27;64:475-483. doi: 10.2340/1651-226X.2025.42032. |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
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Effectiveness. Target: +15% (exploratory). |
| Up to 6 months |
| Change in patient-reported global quality of life measured on a Likert-like scale from 1 (poor) to 5 (excellent). | Effectiveness. Target: +10% relative increase (exploratory). | Up to 6 months |
| Degree to which clinicians and patients (a) open FRAME-PRO during the visit (yes/no), (b) discuss reported needs (yes/no), and (c) manage needs aligned with preferences (yes/no) | Implementation / fidelity | Up to 6 months |
| Perceived feasibility of active FRAME use among clinicians on a likert-like scale from 1 (not feasible) to 5 (very feasible) | Feasibility of FRAME (Proctor outcome) | 6 months |
| Clinician-perceived acceptability of FRAME-supported visits on a scale from 1 (not acceptable) to 5 (very acceptable) | Acceptability (Proctor outcome) | 6 months |
| Perceived fit of FRAME to the oncology outpatient setting and patient population on a scale from 1 (not appropriate) to 5 (very appropriate). | Appropriateness (Proctor outcome) | 6 months |
| Time needed to include FRAME-PRO in the visit on a scale from 1 (definitely shorter time with FRAME) to 5 (definitely longer time with FRAME). | Cost | 6 months |
| Integration of FRAME within the outpatient clinic (e.g., percent of clinicians using FRAME routinely) | Penetration | 6 months |
| Sustained active use of FRAME among clinicians in the last 3 months of the study window. | Maintenance | Up to 12 months |
| Proportion of patients referred to supportive care units (actual numbers) | Effectiveness | 6 months |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |