Breast Cancer Clinical Trial
Official title:
CONTACT: A Prospective Interventional Multicentre Before-after Study for the Implementation of a Care Pathway to Increase Self-management of Patients With Cancer Who Are Treated With Oral Anticancer Medications
This study aims to develop, implement and evaluate a care pathway for patients with cancer
who are treated with oral anticancer drugs (OACD).
The care pathway will be developed in six hospitals in Flanders, and will be adapted to the
local setting and situation.
The investigators hypothesize that the implementation of a care pathway will increase the
quality of the drug therapy, the communication between health care professionals (HCPs) and
patients, and will lead to an improved level of self-management and adherence. Moreover, the
invesitgators hypothesize that the care pathway will facilitate the communication between
HCPs in the hospital setting and in ambulatory care, and will improve counseling skills,
self-efficacy and self-confidence of HCPs.
At the end of the study, a roadmap for the nation-wide implementation of a similar care
pathway will be constructed based on the experiences of the participating hospitals. This
roadmap will certainly include an e-learning platform for healthcare professionals.
For each hospital, an individual care pathway will be developed following the 7-phase model
by Vanhaecht et al., 2011. This methodology aims to offer a systematic approach in 7 phases
for the support of an interdisciplinary team in the development of new care pathways or in
the improvement of existing ones.
The before-part of the study includes phases 1 to 4 that aim to map current practice in
detail and to translate these findings into the development of a care pathway. Current
practice will be investigated using mixed methods comprising:
- surveys evaluating care on the level of the hospital
- semi-structured interviews with healthcare professionals (HCP) and patients
- outcome assessments in patients included in the study (self-management, adherence,
satisfaction with care, satisfaction with information, quality of life) using validated
questionnaires at the start of the therapy, after 1 month and after three months
- outcome assessments in healthcare professionals at baseline (self-efficacy and
perceptions on self-management) using validated questionnaires
- training and feedback sessions on counseling for HCPs
Based upon these findings, a care pathway in each hospital will be developed by a local
project team of different stakeholders from different disciplines.
The after-part of the study includes phase 5-7 in which the care pathway is implemented,
evaluated and continuously followed up.
Implementation and evaluation take place at the same time. The evaluation includes:
- outcome assessments in patients (newly recruited) at the start of the therapy, after 1
month and after three months
- outcome assessments in HCPs (follow up)
- evaluation of counseling skills
- focus group discussions and interviews with HCPs to evaluate the development and
implementation of the care pathway.
At the end of the study a comparison of outcomes before and after the implementation will be
made to study the impact of the care pathway on the before mentioned aspects (see "Brief
Summary").
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