Improving continuity by bringing the cancer patient, general practitioner and oncologist together in a shared video-based consultation – protocol for a randomised controlled trial

Abstract

Background Strengthening the coordination, continuity and intersectoral cooperation for cancer patients’ during cancer treatment is being underlined by international guidelines and research. General practitioners have assumed a growing role in the cancer patient disease trajectory because of their roles as coordinators and the consistent health provider. However, general practitioners are challenged in providing support for cancer patients both during treatment and in the survivorship phase. General practitioners reported barriers are lack of timely and relevant communication from the oncologist and limited knowledge to guidelines, as well as lack of trust from patients. Therefore, the current study will examine whether a shared video-based consultation between the cancer patient, general practitioner and oncologist can ease general’ challenges and thereby enhance the patient-centeredness for the cancer patients and their perception of intersectoral cooperation and continuity. Methods The study is designed as a pragmatic randomised controlled trial for patients starting chemotherapy at the Department of Oncology, Lillebaelt Hospital, Denmark who are listed with a general practitioner in the Region of Southern Denmark. We intend to include 278 adults diagnosed with colorectal, breast, lung, gynecologic or prostate cancer. The intervention group will receive the “Partnership intervention” which consists of one or more video-consultations between the cancer patient, general practitioner and oncologist. The consultations are estimated to last between 10 and 20 min. The specific aims of the consultation are, summary of the patient trajectory, sharing of knowledge regarding comorbidity, psychosocial resources and needs, physical well-being, medicine, anxiety and depression symptoms, spouses, workability and late complication and side-effects to the cancer treatment. Discussion Video-based consultation that brings the cancer patient, the general practitioner and the oncologist together in the early phase of treatment may facilitate a sense of partnership that is powerful enough to improve the patient’s perception of intersectoral cooperation, continuity of cancer care and health-related quality of life. Trial registration ClincialTrials.gov Identifier: NCT02716168 . Date of registration: 03.03.2016. Electronic supplementary material The online version of this article (10.1186/s12875-019-0978-8) contains supplementary material, which is available to authorized users.

Cross-sectoral video consultation in cancer care: GPs’ evaluation of a randomised controlled trial

“…Inclusion of patients was accomplished between June 2016 and November 2019. Patient perception of coordination of care at seven months' follow-up was the primary outcome (22). This paper follows the CONSORT statement(25) (Supplementary Table 1).…”

“…Patients were invited into the study at the Department of Oncology, Lillebaelt Hospital, if above 18 years, treated with chemotherapy for a newly diagnosed cancer, and listed with a general practice in the Region of Southern Denmark. Practitioners were all specialists in family medicine (22). Around 1,300 cancer patients are referred to chemotherapy at the Department of Oncology, annually.…”

“…We developed a GP questionnaire (22) including the number of patient visits to the GP and 28 items covering five different themes: GP assessment of the contact between the Hospital (2 items), information from the Hospital to the GP (7 items), GP involvement in the trajectory (6 items), information from the Hospital to help the GP (6 items) and GP satisfaction with the distribution of task and roles (7 items) (Supplementary Table 2). All questionnaires were measured on a 4-point Likert scale and used the following "not at all"," little", "partly" and "a lot" or, for linguistic reasons, "very insufficient", "partly insufficient", "satisfactory" and "very satisfactory".…”

“…The number of GPs invited was based on sample size calculations, i.e. the primary, patient-reported outcome (22). Our goal was to include 278 patients (Figure 1).…”

“…Recent trials have included GPs (19) or patients (20,21), but not simultaneously. Therefore, we developed the Partnership shared care model, including multidisciplinary video consultations between a cancer patient, oncologist and GP (22). Based on a randomised controlled trial, this paper aims to test the effects on GP perceived involvement in cancer care and their satisfaction with cross-sectoral information and coordination of care.…”