A randomized controlled trial of a nurse-led supportive care package (Survivorcare) for survivors of colorectal cancer

Michael Jefford, Karla Gough, Allisondros Dowsky, Lahiru Russell, Sanchia Aranda, Phyllis Butow, Jo Phipps-Nelson, Jane Young, Mei Krishnasamy, Anna Ugalde, Dorothy King, Andrew Strickland, Michael Franco, Robert Blum, Catherine Johnson, Vinod Ganju, Jeremy Shapiro, Geoffrey Chong, Julie Charlton, Andrew HaydonPenelope Schofield

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25 Citations (Scopus)

Abstract

Introduction. Colorectal cancer (CRC) and its treatments can cause distressing sequelae.We conducted amulticenter randomized controlled trial aiming to improve psychological distress, supportive care needs (SCNs), and quality of life (QOL) of patients with CRC. The intervention, called SurvivorCare (SC), comprised educational materials, needs assessment, survivorship care plan, end-of-treatment session, and three follow-up telephone calls. Methods. At the end of treatment for stage I–III CRC, eligible patients were randomized 1:1 to usual care (UC) or to UC plus SC. Distress (Brief Symptom Inventory 18), SCNs (Cancer Survivors’ Unmet Needs measure), and QOL (European Organization for Research and Treatment of Cancer [EORTC] QOL questionnaires C30 and EORTC CRC module CR29) were assessed at baseline and at 2 and 6 months (follow-up 1 [FU1] and FU2, respectively). The primary hypothesis was that SC would have a beneficial effect on distress at FU1. The secondary hypotheses were that SC would have a beneficial effect on (a) SCN and QOL at FU1 and on (b) distress, SCNs, and QOL at FU2. A total of 15 items assessed experience of care. Results. Of 221 patients randomly assigned, 4 were ineligible for thestudyand1waslost toFU, leaving 110 in the UC group and 106 in the SC group. Patients’ characteristics included the following: median age, 64 years; men,52%; colon cancer, 56%; rectal cancer, 35%; overlapping sites of disease, 10%; stage I disease, 7%; stage II, 22%; stage III, 71%. Baseline distress and QOL scores were similar to population norms. Between-group differences in distress at FU1 (primary outcome) and at FU2, and SCNs and QOL at FU1 and FU2 were small and non significant.Patients inthe SC group were more satisfied with survivorship care than those in the UC group (significant differences on 10 of 15 items). Conclusion. The addition of SC to UC did not have a beneficial effect on distress, SCNs, or QOL outcomes, but patients in the SC group were more satisfied with care.

Original languageEnglish
Pages (from-to)1014-1023
Number of pages10
JournalOncologist
Volume21
Issue number8
DOIs
Publication statusPublished - 1 Aug 2016
Externally publishedYes

Keywords

  • Colorectal cancer
  • Distress
  • Nurse
  • Quality of life
  • Randomized controlled trial
  • Survivors

Cite this

Jefford, M., Gough, K., Dowsky, A., Russell, L., Aranda, S., Butow, P., Phipps-Nelson, J., Young, J., Krishnasamy, M., Ugalde, A., King, D., Strickland, A., Franco, M., Blum, R., Johnson, C., Ganju, V., Shapiro, J., Chong, G., Charlton, J., ... Schofield, P. (2016). A randomized controlled trial of a nurse-led supportive care package (Survivorcare) for survivors of colorectal cancer. Oncologist, 21(8), 1014-1023. https://doi.org/10.1634/theoncologist.2015-0533