Randomized pilot evaluation of the supportive care intervention "CONNECT" for people following surgery for colorectal cancer.

Abstract

Improvements can be made in the quality of cancer care if supportive care needs are addressed; however, there are few trials of supportive care interventions to guide policy and practice. This study aimed to determine the effectiveness of a nurse-delivered telephone supportive intervention (the "CONNECT" intervention). This study was a pilot randomized controlled trial. Intervention group patients received 5 calls from a specialist colorectal nurse in the 6 months after hospital discharge. Each call was standardized, comprising the assessment of unmet need and the provision of information and emotional support. CONNECT was in addition to standard clinical follow-up. Patients allocated to the control group received standard follow-up only. This study took place at the Royal Prince Alfred Hospital, Sydney, Australia. Patients (n = 75) were included who had been surgically treated for colorectal cancer (any stage). The main outcome measures were the unmet supportive care needs, health service utilization, and quality of life at 1, 3, and 6 months postdischarge. Of 87 eligible patients, 75 consented (86% consent rate). Thirty-nine patients were randomly assigned to CONNECT and 36 to usual care. At 6 months, there was a clinically relevant, but nonsignificant reduction in presentations to emergency departments (21% vs 33%; χ1 = 1.41, P = .23) and readmission to the hospital (37% vs 47%; χ1 = 0.82, P = .37) among intervention compared with control group participants. Nonsignificant differences between groups were found for all unmet supportive care need and quality-of-life scores, change scores, and trends. However, at 6 months, total quality-of-life scores were higher for intervention group patients than controls (106.0 vs 98.6). This difference (7.4) was clinically relevant. Improvements in total quality-of-life change scores demonstrated that at 6 months, improvements were more than twice as large and clinically significant in the intervention compared with the control group. CONNECT has shown promising indications on health system and patient outcomes that warrant a larger study to further investigate the potential of this intervention.