title: A randomised controlled trial of hospital-based case management to improve colorectal cancer patients' health-related quality of life and evaluations of care.
abstract: OBJECTIVE
  To analyse the effectiveness of hospital-based case management (CM) in terms of patient-reported outcomes.
  
  
  METHODS
  Randomised controlled trial allocating participants 1 : 1 to either a CM intervention or a control group. Allocation status was evident to participants and case managers, but blinded to researchers.
  
  
  METHODS
  Patients were recruited at a Danish surgical department where the case managers were situated.
  
  
  METHODS
  Colorectal cancer patients who were to undergo further investigation or treatment. Exclusion criteria were participation in another study, poor Danish language skills or apparent cognitive impairment. 140 participants were randomised to each group. Recruitment period was 11 March 2009 to 29 December 2010.
  
  
  METHODS
  Control group patients had usual care. Intervention group patients had usual care supplemented by hospital-based CM started at first visit to the out-patient clinic (before treatment start) and ended 4 weeks after completed cancer treatment. CM was conducted by nurse case managers who undertook care pathway supervision, information dissemination to health professionals and outreaching patient support.
  
  
  METHODS
  Patient-reported global quality of life measured with the EORTC QLQ-C30 and eight ad hoc, piloted patient evaluation items assessed at eight, 30 and 52 weeks after randomisation.
  
  
  RESULTS
  The two groups were comparable as to questionnaire response rates and completed scales/items. There were no statistically significant group differences on any of the health-related quality of life subscales at eight, 30 or 52 weeks. In patient evaluations, all point estimates favoured CM at week 8 and 30; at week 52, 6 of 7 estimates favoured CM.
  
  
  CONCLUSIONS
  We found no evidence that CM influenced colorectal cancer patients' health-related quality of life. Patients allocated to CM evaluated their care more positively than patients receiving usual care.
  
  
  BACKGROUND
  Clinicaltrials.gov identifier: NCT00845247.
authors.affiliation: The Research Unit for General Practice in Aarhus, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Christian Nielsen
authors.initials: CN
authors.lastname: Wulff
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.forename: Jens
authors.initials: J
authors.lastname: Søndergaard