title: Multicenter randomized trial of centralized nurse-led telephone-based care coordination to improve outcomes after surgical resection for colorectal cancer: the CONNECT intervention.
abstract: OBJECTIVE
  To investigate the effectiveness of a centralized, nurse-delivered telephone-based service to improve care coordination and patient-reported outcomes after surgery for colorectal cancer.
  
  
  METHODS
  Patients with a newly diagnosed colorectal cancer were randomly assigned to the CONNECT intervention or usual care. Intervention-group patients received standardized calls from the centrally based nurse 3 and 10 days and 1, 3, and 6 months after discharge from hospital. Unmet supportive care needs, experience of care coordination, unplanned readmissions, emergency department presentations, distress, and quality of life (QOL) were assessed by questionnaire at 1, 3, and 6 months.
  
  
  RESULTS
  Of 775 patients treated at 23 public and private hospitals in Australia, 387 were randomly assigned to the intervention group and 369 to the control group. There were no significant differences between groups in unmet supportive care needs, but these were consistently low in both groups at both follow-up time points. There were no differences between the groups in emergency department presentations (10.8% v 13.8%; P = .2) or unplanned hospital readmissions (8.6% v 10.5%; P = .4) at 1 month. By 6 months, 25.6% of intervention-group patients had reported an unplanned readmission compared with 27.9% of controls (P = .5). There were no significant differences in experience of care coordination, distress, or QOL between groups at any follow-up time point.
  
  
  CONCLUSIONS
  This trial failed to demonstrate substantial benefit of a centralized system to provide standardized, telephone follow-up for postoperative patients with colorectal cancer. Future interventions could investigate a more tailored approach.
authors.affiliation: Jane M. Young, Phyllis N. Butow, Jennifer Walsh, Ivana Durcinoska, Timothy A. Dobbins, Laura Rodwell, James D. Harrison, Kate White, Christopher M. Byrne, Christopher J. Young, and Michael J. Solomon, University of Sydney; Jane M. Young, Jennifer Walsh, Ivana Durcinoska, James D. Harrison, and Michael J. Solomon, Surgical Outcomes Research Centre, Sydney Local Health District; Christopher M. Byrne, Christopher J. Young, Anthony Eyers, Peter Lee, and Michael J. Solomon, Royal Prince Alfred Hospital; Alan P. Meagher, St Vincent's Hospital; Grahame Ctercteko and Nimalan Pathma-Nathan, Westmead Hospital, Sydney; Andrew Gilmore, Orange Base Hospital, Orange; Bruce Hodge and Greg Longfield, Port Macquarie Base Hospital, Port Macquarie; Henry Hicks and Stephen Jancewicz, Wagga Wagga Base Hospital, Wagga Wagga; Stephen Smith, John Hunter Hospital, Newcastle; Geoff O'Connor and Dean Fisher, Dubbo Base Hospital, Dubbo; Andrew Sutherland and Ned S. Abraham, Coffs Harbour Base Hospital, Coffs Harbour; Austin Curtin and David Townend, Lismore Base Hospital, Lismore, New South Wales; and David Rangiah, Canberra Hospital, Australian Capital Territory, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Young
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.forename: Jennifer
authors.initials: J
authors.lastname: Walsh
authors.forename: Ivana
authors.initials: I
authors.lastname: Durcinoska
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Dobbins
authors.forename: Laura
authors.initials: L
authors.lastname: Rodwell
authors.forename: James D
authors.initials: JD
authors.lastname: Harrison
authors.forename: Kate
authors.initials: K
authors.lastname: White
authors.forename: Andrew
authors.initials: A
authors.lastname: Gilmore
authors.forename: Bruce
authors.initials: B
authors.lastname: Hodge
authors.forename: Henry
authors.initials: H
authors.lastname: Hicks
authors.forename: Stephen
authors.initials: S
authors.lastname: Smith
authors.forename: Geoff
authors.initials: G
authors.lastname: O'Connor
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Byrne
authors.forename: Alan P
authors.initials: AP
authors.lastname: Meagher
authors.forename: Stephen
authors.initials: S
authors.lastname: Jancewicz
authors.forename: Andrew
authors.initials: A
authors.lastname: Sutherland
authors.forename: Grahame
authors.initials: G
authors.lastname: Ctercteko
authors.forename: Nimalan
authors.initials: N
authors.lastname: Pathma-Nathan
authors.forename: Austin
authors.initials: A
authors.lastname: Curtin
authors.forename: David
authors.initials: D
authors.lastname: Townend
authors.forename: Ned S
authors.initials: NS
authors.lastname: Abraham
authors.forename: Greg
authors.initials: G
authors.lastname: Longfield
authors.forename: David
authors.initials: D
authors.lastname: Rangiah
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Young
authors.forename: Anthony
authors.initials: A
authors.lastname: Eyers
authors.forename: Peter
authors.initials: P
authors.lastname: Lee
authors.forename: Dean
authors.initials: D
authors.lastname: Fisher
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D003266:Continuity of Patient Care; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009726:Nurses; D017063:Outcome Assessment, Health Care; D010166:Palliative Care; D010359:Patient Readmission; D018802:Patient-Centered Care; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013689:Telephone; D013997:Time Factors