Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods

Sandsund, C, Towers, R, Thomas, K, Tigue, R, Lalji, A, Doyle, N, Jordan, Jake, Gage, Heather and Shaw, C (2017) Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods BMJ Supportive & Palliative Care, 72 (1). S175-S175.

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Abstract

Holistic needs assessment (HNA) and care planning is proposed to address unmet needs of people treated for cancer. We tested whether HNA and care planning by an allied health professional improved cancer-specific quality of life for women following curative treatment for stage I-III gynaecological cancer. Methods Consecutive women were invited to participate in a randomised controlled study (HNA and care planning vs. usual care) at a UK cancer centre. Data were collected by questionnaire at baseline, three and six months. The outcomes were six month change in EORTC-QLQ-C30 global score (primary), and in EORTC sub-scales, generic quality of life, self-efficacy (secondary). The study was blinded for data management and analysis. Differences in outcomes were compared between groups. Health service utilisation and Quality Adjusted Life Years (from SF-6) were gathered for a cost-effectiveness analysis. Thematic analysis was used to interpret data from an exit interview. Results 150 women consented (75 per group), ten undertook interviews. For 124 participants (61 intervention, 63 controls) with complete data, no statistically significant differences were seen between groups in the primary end-point. The majority of those interviewed reported important personal gains they attributed to the intervention which reflected trends to improvement seen in EORTC functional and symptom scales. Economic analysis suggests a 62% probability of cost-effectiveness at a £30,000/QALY threshold. Conclusion: Care plan development with an allied health professional is cost-effective, acceptable and useful for some women treated for stage 1-111 gynaecological cancer. We recommend its introduction early in the pathway to support person-centred care.

Item Type:	Article
Subjects :	Economics
Divisions :	Faculty of Arts and Social Sciences > School of Economics
Authors :	Name Email ORCID Sandsund, C Towers, R Thomas, K Tigue, R Lalji, A Doyle, N Jordan, Jake jake.jordan@surrey.ac.uk Gage, Heather H.Gage@surrey.ac.uk Shaw, C
Date :	9 August 2017
DOI :	10.1016/S0959-8049(17)30644-5
Copyright Disclaimer :	Copyright 2017 The Author(s)
Related URLs :	Publisher
Depositing User :	Symplectic Elements
Date Deposited :	09 May 2017 15:24
Last Modified :	16 Jan 2019 17:14
URI:	http://epubs.surrey.ac.uk/id/eprint/814135

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