Facilitating needs based cancer care for people with a chronic disease: Evaluation of an intervention using a multi-centre interrupted time series design.
BACKGROUND
Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis [1]. This paper presents a study designed to assess the feasibility and efficacy of an intervention to assist in the allocation of palliative care resources according to need, within the context of a population of people with advanced cancer.


METHODS
People with advanced cancer and their caregivers completed bi-monthly telephone interviews over a period of up to 18 months to assess unmet needs, anxiety and depression, quality of life, satisfaction with care and service utilisation. The intervention, introduced after at least two baseline phone interviews, involved a) training medical, nursing and allied health professionals at each recruitment site on the use of the Palliative Care Needs Assessment Guidelines and the Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C); b) health professionals completing the NAT: PD-C with participating patients approximately monthly for the rest of the study period. Changes in outcomes will be compared pre-and post-intervention.


CONCLUSIONS
The study will determine whether the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings is a feasible and effective strategy for facilitating the timely provision of needs based care.


BACKGROUND
ISRCTN21699701.
Waller
Amy
A
Centre for Health Research & Psycho-oncology, The Cancer Council NSW, University of Newcastle, Hunter Medical Research Institute & Priority Research Centre in Health Behaviour, Callaghan, Australia.
Girgis
Afaf
A
Johnson
Claire
C
Mitchell
Geoff
G
Yates
Patsy
P
Kristjanson
Linda
L
Tattersall
Martin
M
Lecathelinais
Christophe
C
Sibbritt
David
D
Kelly
Brian
B
Gorton
Emma
E
Currow
David
D