Skip to main content
Top
Published in: Supportive Care in Cancer 1/2012

01-01-2012 | Original Article

Examining the introduction of a supportive care screening and referral process for cancer patients: how does practice compare with protocols?

Authors: Melanie Regan, Eli Ristevski, Rebecca Jones, Sibilah Breen, Allison Hartney

Published in: Supportive Care in Cancer | Issue 1/2012

Login to get access

Abstract

Purpose

The aim of this study was to examine the introduction of a supportive care screening and referral process into clinical practice for patients with cancer, and to determine how clinicians' actions compared to evidence-based protocols contained within the Supportive Care Resource Kit.

Methods

A Supportive Care Resource Kit was developed as a resource for clinicians to enable a systematic process of screening cancer patients for unmet supportive care needs and addressing these needs by using evidence-based protocols. Clinicians were recruited and trained in supportive care and the use of the kit. Patients were recruited and screened for their supportive care needs. Patients and clinicians undertook a problem solving discussion, which was documented and analysed using content analysis.

Results

In applying the screening process, clinicians undertook discussion, referral and information provision with patients. Comparison to evidence-based protocols revealed that practice was predominantly in line with protocols. Overall, clinicians' practice matched well with guidance from the protocols on discussion and referral, but less so in providing information to patients. Actions taken between supportive care domains differed with clinician preference evident for dealing with physical problems compared with practical, emotional and family problems.

Conclusions

Implications for practice and research include, exploring strategies for broadening clinician confidence in dealing with all areas of supportive care needs; undertaking further research into the use of protocols in health care and incorporating strategic, multidisciplinary planning in protocol implementation schemes.
Literature
1.
go back to reference National Institute for Clinical Excellence (2004) Improving supportive and palliative care for adults with cancer: The manual. National Institute for Clinical Excellence, London National Institute for Clinical Excellence (2004) Improving supportive and palliative care for adults with cancer: The manual. National Institute for Clinical Excellence, London
2.
go back to reference National Comprehensive Cancer Network (2010) NCCN clinical practice guidelines in oncology. Distress management, version 1.2010 National Comprehensive Cancer Network (2010) NCCN clinical practice guidelines in oncology. Distress management, version 1.2010
3.
go back to reference Centre National Breast Cancer, Initiative National Cancer Control (2003) Clinical practice guidelines for the psychosocial care of adults with cancer. National Breast Cancer Centre, Camperdown Centre National Breast Cancer, Initiative National Cancer Control (2003) Clinical practice guidelines for the psychosocial care of adults with cancer. National Breast Cancer Centre, Camperdown
4.
go back to reference Girgis A, Breen S, Stacey F, Lecathelinais C (2009) Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. J Clin Oncol 27(36):6180–6190. doi:10.1200/JCO.2009.22.8718 PubMedCrossRef Girgis A, Breen S, Stacey F, Lecathelinais C (2009) Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. J Clin Oncol 27(36):6180–6190. doi:10.​1200/​JCO.​2009.​22.​8718 PubMedCrossRef
5.
go back to reference Clover K, Carter GL, MacKinnon A, Adams C (2009) Is my patient suffering clinically significant emotional distress? Demonstration of a probabilities approach to evaluating algorithms for screening for distress. Support Care Cancer 17:1455–1462. doi:10.1007/s00520-009-0606-6 PubMedCrossRef Clover K, Carter GL, MacKinnon A, Adams C (2009) Is my patient suffering clinically significant emotional distress? Demonstration of a probabilities approach to evaluating algorithms for screening for distress. Support Care Cancer 17:1455–1462. doi:10.​1007/​s00520-009-0606-6 PubMedCrossRef
8.
go back to reference Macvean ML, White VM, Pratt S, Grogan S, Sanson-Fisher R (2007) Reducing the unmet needs of patients with colorectal cancer: a feasibility study of the pathfinder volunteer program. Support Care Cancer 15:293–299. doi:10.1007/s00520-006-0128-4 PubMedCrossRef Macvean ML, White VM, Pratt S, Grogan S, Sanson-Fisher R (2007) Reducing the unmet needs of patients with colorectal cancer: a feasibility study of the pathfinder volunteer program. Support Care Cancer 15:293–299. doi:10.​1007/​s00520-006-0128-4 PubMedCrossRef
9.
go back to reference McLachlan SA, Allenby A, Matthews J, Wirth A, Kissane D, Bishop M, Beresford J, Zalcberg J (2001) Randomised trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol 19:4117–4125PubMed McLachlan SA, Allenby A, Matthews J, Wirth A, Kissane D, Bishop M, Beresford J, Zalcberg J (2001) Randomised trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol 19:4117–4125PubMed
10.
go back to reference Siegel K, Mesagno FM, Karus DG, Christ G (1992) Reducing the prevalence of unmet needs for concrete services of patients with cancer: evaluation of a computerized telephone outreach system. Cancer 69:1873–1883PubMedCrossRef Siegel K, Mesagno FM, Karus DG, Christ G (1992) Reducing the prevalence of unmet needs for concrete services of patients with cancer: evaluation of a computerized telephone outreach system. Cancer 69:1873–1883PubMedCrossRef
11.
go back to reference Velikova G, Booth L, Smith A, Brown P, Lynch P, Brown J, Selby P (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomised controlled trial. J Clin Oncol 22:714–724PubMedCrossRef Velikova G, Booth L, Smith A, Brown P, Lynch P, Brown J, Selby P (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomised controlled trial. J Clin Oncol 22:714–724PubMedCrossRef
16.
go back to reference Ristevski E, Breen S, Regan M (2008) The supportive care resource kit: a training and resource kit for health practitioners. Monash University Department of Rural and Indigenous Health & Gippsland Regional Integrated Cancer Services, Gippsland Ristevski E, Breen S, Regan M (2008) The supportive care resource kit: a training and resource kit for health practitioners. Monash University Department of Rural and Indigenous Health & Gippsland Regional Integrated Cancer Services, Gippsland
17.
go back to reference Gross PA, Greenfield S, Cretin S, Ferguson J, Grimshaw J, Grol R, Klazinga N, Lorenz W, Meyer GS, Riccobono C, Schoenbaum SC, Schyve P, Shaw C (2001) Optimal methods for guideline implementation: conclusions from Leeds Castle meeting. Med Care 39(8 Suppl 2):II85–II92PubMed Gross PA, Greenfield S, Cretin S, Ferguson J, Grimshaw J, Grol R, Klazinga N, Lorenz W, Meyer GS, Riccobono C, Schoenbaum SC, Schyve P, Shaw C (2001) Optimal methods for guideline implementation: conclusions from Leeds Castle meeting. Med Care 39(8 Suppl 2):II85–II92PubMed
18.
go back to reference Foster JA, Abdolrasulnia M, Doroodchi H, McClure J, Casebeer L (2009) Practice patterns and guideline adherence of medical oncologists in managing patients with early breast cancer. J Natl Compr Cancer Netw 7(7):697–706 Foster JA, Abdolrasulnia M, Doroodchi H, McClure J, Casebeer L (2009) Practice patterns and guideline adherence of medical oncologists in managing patients with early breast cancer. J Natl Compr Cancer Netw 7(7):697–706
19.
go back to reference Redman S, Turner J, Davis C (2003) Improving supportive care for women with breast cancer in Australia: the challenge of modifying health systems. Psychooncology 12:521–531. doi:10.1002/pon.690 PubMedCrossRef Redman S, Turner J, Davis C (2003) Improving supportive care for women with breast cancer in Australia: the challenge of modifying health systems. Psychooncology 12:521–531. doi:10.​1002/​pon.​690 PubMedCrossRef
22.
go back to reference Pirl WF, Muriel A, Hwang V, Kornblith A, Greer J, Donelan K, Greenberg DB, Temel J, Schapira L (2007) Screening for psychosocial distress: a national survey of oncologists. J Support Oncol 5(10):499–504PubMed Pirl WF, Muriel A, Hwang V, Kornblith A, Greer J, Donelan K, Greenberg DB, Temel J, Schapira L (2007) Screening for psychosocial distress: a national survey of oncologists. J Support Oncol 5(10):499–504PubMed
25.
go back to reference National Comprehensive Cancer Network (2008) NCCN clinical practice guidelines in oncology. Distress management, version 1.2008 National Comprehensive Cancer Network (2008) NCCN clinical practice guidelines in oncology. Distress management, version 1.2008
26.
go back to reference Lupton D (1999) Content analysis. In: Minichiello V, Sullivan G, Greenwood K, Axford R (eds) Handbook for Research Methods in Health Sciences, Pearson Education Australia Sydney, pp. 450–461 Lupton D (1999) Content analysis. In: Minichiello V, Sullivan G, Greenwood K, Axford R (eds) Handbook for Research Methods in Health Sciences, Pearson Education Australia Sydney, pp. 450–461
27.
go back to reference Fitch M (2000) Supportive care for cancer patients. Hosp Quart 3:39–46 Fitch M (2000) Supportive care for cancer patients. Hosp Quart 3:39–46
28.
go back to reference Department of Human Services Victoria (2009) Providing optimal cancer care: supportive care policy for Victoria. Metropolitan Health and Aged Care Services Division, Victorian Government Department of Human Services, Victoria Department of Human Services Victoria (2009) Providing optimal cancer care: supportive care policy for Victoria. Metropolitan Health and Aged Care Services Division, Victorian Government Department of Human Services, Victoria
30.
31.
go back to reference Towers R (2007) Providing psychological support for patients with cancer. Nurs Stand 22:50–57PubMed Towers R (2007) Providing psychological support for patients with cancer. Nurs Stand 22:50–57PubMed
32.
go back to reference Ristevski E, Breen S, Regan M. Incorporating supportive care into routine cancer care: the benefits and challenges to clinicians' practice. Oncol Nurs Forum. In press Ristevski E, Breen S, Regan M. Incorporating supportive care into routine cancer care: the benefits and challenges to clinicians' practice. Oncol Nurs Forum. In press
33.
go back to reference Fitch MI (2008) Supportive care framework. Can Oncol Nurs J 18(1):6–24PubMed Fitch MI (2008) Supportive care framework. Can Oncol Nurs J 18(1):6–24PubMed
34.
35.
go back to reference Lia-Hoagberg B, Schaffer M, Strohschein S (1999) Public health nursing practice guidelines: an evaluation of dissemination and use. Public Health Nurs 16(6):397–404PubMedCrossRef Lia-Hoagberg B, Schaffer M, Strohschein S (1999) Public health nursing practice guidelines: an evaluation of dissemination and use. Public Health Nurs 16(6):397–404PubMedCrossRef
Metadata
Title
Examining the introduction of a supportive care screening and referral process for cancer patients: how does practice compare with protocols?
Authors
Melanie Regan
Eli Ristevski
Rebecca Jones
Sibilah Breen
Allison Hartney
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 1/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-010-1074-8

Other articles of this Issue 1/2012

Supportive Care in Cancer 1/2012 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine