A major challenge in value-based health care is the lack of standardized health outcomes measurements, hindering optimal monitoring and comparison of the quality of health care across different settings globally. The International Consortium for Health Outcomes Measurement (ICHOM) assembled a multidisciplinary international working group, comprised of 26 health care providers and patient advocates, to develop a standard set of value-based patient-centered outcomes for breast cancer (BC). The working group convened via 8 teleconferences and completed a follow-up survey after each meeting. A modified 2-round Delphi method was used to achieve consensus on the outcomes and case-mix variables to be included. Patient focus group meetings (8 early or metastatic BC patients) and online anonymized surveys of 1225 multinational BC patients and survivors were also conducted to obtain patients' input. The standard set encompasses survival and cancer control, and disutility of care (eg, acute treatment complications) outcomes, to be collected through administrative data and/or clinical records. A combination of multiple patient-reported outcomes measurement (PROM) tools is recommended to capture long-term degree of health outcomes. Selected case-mix factors were recommended to be collected at baseline. The ICHOM will endeavor to achieve wide buy-in of this set and facilitate its implementation in routine clinical practice in various settings and institutions worldwide.

Psychoeducational interventions, including relaxation, seem to alleviate hot flashes in menopausal women and breast cancer survivors; however, the methodological quality of published research is either fair or poor. More studies are required, especially in the breast cancer population where only a few studies are available, before psychoeducational interventions are offered as a treatment option.

Health ICT is rapidly gaining popularity among policy makers and health consumers. Specific platforms for use in cancer care are missing. Aim: The aim of this pilot study was to: 1) test the feasibility, functionality and usability of a patient-led cancer care web platform: CanCare, in a sample of people undergoing cancer treatment and 2) ascertain if CanCare could enhance communication between patients, family, friends and health professionals. Methods: Cancer patients receiving chemotherapy were invited to participate. Data were collected via semi-structured interviews, online surveys and a website usage program. Results: Nine patients with four different types of cancer completed the study. All saw the potential of the website but many found it too complex to use, particularly when unwell post treatment. Many were frustrated by the lack of integration with existing hospital systems and the need to enter relevant data manually. The cancer-specific information tab rated highly and was used extensively. The website used alone did not promote interactions between family and/or health professionals. Conclusion: A patient-led cancer care website has the potential to help patients manage their cancer care but needs to be intuitive to use, integrated into hospital systems and requires significant family/carer and health professional engagement.

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The role of the internet, and in particular e-health, in chronic illness is a burgeoning phenomenon but its use to date in cancer care is somewhat limited. In this study an iterative consultative process was undertaken with the aim to develop a cancer care website that was patient-led, facilitated cancer self-management and had the potential to improve communication between patients, family and friends and health care professionals. The process involved multiple demonstrations of an already established base platform (SeeCare ß ) to potential end users (patients, family members and friends and health professionals) to identify required functions of a cancer care specific platform. An exhaustive list of specifications was prioritised and operationalised resulting in a web platform for people affected by cancer that was ready for testing in the clinical setting: CanCare.

9124 Background: Improved treatments mean women with advanced breast cancer (ABC) are living longer, sometimes for many years. As a result, these women may experience chronic needs that are different from those with early breast cancer. We aimed to assess the support and information needs of women living with ABC. Methods: A national postal survey was sent to 2,345 women with ABC registered as members of the consumer organizations BCNA and/or BreaCan. Women were asked about their disease, treatment, experiences of care, and to complete the Supportive Care Needs Survey. Results: The response rate was 34% (792 valid responses). Mean age was 57 (range 25-99) with 21% living alone and 27% working. 18% reported living with ABC for >7 years. 656 (85%) were having current treatment: chemotherapy (43%), hormonal therapy (46%), bisphosphonates (49%), and/or trastuzumab (Herceptin) (19%) respectively. 49% of women reported having access to a Breast Care Nurse (BCN) since diagnosis of ABC but only 3% cited a BCN or cancer nurse as their main contact. The majority (76%) cited their medical oncologist as their main contact, 8% cited their family doctor. Women wanted information about: treatment options (84.2%), new treatments (79.2%), symptoms/side effects (78.9%), clinical trials (60.8%), managing pain (57.2%) and financial assistance (38%). Women ≤ 65 had significantly higher levels of unmet needs than those >65 for the 7 items below, including all items from the sexual domain. Conclusions: Women with ABC have many unmet needs with younger women particularly needing more support with sexual needs and anxiety. Women are heavily reliant on their medical oncologist, who may not be equipped or best placed to meet these needs. Models of care need to be developed to address the unmet supportive care needs of women living with ABC. [Table: see text]

Despite the prolonged survival of many patients with advanced cancer and the increasing conceptualization of cancer as a chronic illness, care delivery systems within the Australian context continue to manage advanced cancer as an acute illness. Patients living with advanced cancer are managed alongside those with curable cancers in ambulatory models of care that centre on diagnosis, treatment decision-making or post treatment surveillance. Conversely, the needs of people with advanced disease are often complex, requiring high levels of collaboration between providers across acute, palliative and primary care settings in order to move forwards to a more person-centered approach to care. Aims: This paper addresses three specific aims: 1. to identify the care requirements and concerns of patients and their carers; 2. to examine the role of out-reach telephone calls as a component of care; 3. to identify the nurse's role in care coordination for patients with advanced cancer. Method: Two nurse clinician researchers (CR) managed a cohort of patients with advanced breast (n=12) and gastrointestinal cancers (n=16) over six and nine months respectively. Data were recorded on every interaction between the CRs and the patients, carers and other health professionals. The CRs were interviewed by an independent nurse researcher. Results: The symptoms and issues causing concern to patients and/or carers included pain, weakness, gastrointestinal symptoms, managing appointments and dealing with anxiety. The CR played a major role in coordinating care to address these concerns and found out-reach telephone calls facilitated the process. Conclusions: Patients with advanced cancer have complex needs and care coordination requirements not routinely met in an acute care setting. Input from a nurse working at an advanced level and the use of out-reach telephone calls can assist in meeting these care needs.

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