Multicenter randomized trial of centralized nurse-led telephone-based care coordination to improve outcomes after surgical resection for colorectal cancer

the CONNECT Intervention

Jane M. Young*, Phyllis N. Butow, Jennifer Walsh, Ivana Durcinoska, Timothy A. Dobbins, Laura Rodwell, James D. Harrison, Kate White, Andrew Gilmore, Bruce Hodge, Henry Hicks, Stephen Smith, Geoff O'Connor, Christopher M. Byrne, Alan P. Meagher, Stephen Jancewicz, Andrew Sutherland, Grahame Ctercteko, Nimalan Pathma-Nathan, Austin Curtin & 9 others David Townend, Ned S. Abraham, Greg Longfield, David Rangiah, Christopher J. Young, Anthony Eyers, Peter Lee, Dean Fisher, Michael J. Solomon

*Corresponding author for this work

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

To investigate the effectiveness of a centralized, nurse-delivered telephone-based service to improve care coordination and patient-reported outcomes after surgery for colorectal cancer. Patients with a newly diagnosed colorectal cancer were randomly assigned to the CONNECT intervention or usual care. Intervention-group patients received standardized calls from the centrally based nurse 3 and 10 days and 1, 3, and 6 months after discharge from hospital. Unmet supportive care needs, experience of care coordination, unplanned readmissions, emergency department presentations, distress, and quality of life (QOL) were assessed by questionnaire at 1, 3, and 6 months. Of 775 patients treated at 23 public and private hospitals in Australia, 387 were randomly assigned to the intervention group and 369 to the control group. There were no significant differences between groups in unmet supportive care needs, but these were consistently low in both groups at both follow-up time points. There were no differences between the groups in emergency department presentations (10.8% v 13.8%; P = .2) or unplanned hospital readmissions (8.6% v 10.5%; P = .4) at 1 month. By 6 months, 25.6% of intervention-group patients had reported an unplanned readmission compared with 27.9% of controls (P = .5). There were no significant differences in experience of care coordination, distress, or QOL between groups at any follow-up time point. This trial failed to demonstrate substantial benefit of a centralized system to provide standardized, telephone follow-up for postoperative patients with colorectal cancer. Future interventions could investigate a more tailored approach.

Original languageEnglish
Pages (from-to)3585-3591
Number of pages7
JournalJournal of Clinical Oncology : official journal of the American Society of Clinical Oncology
Volume31
Issue number28
DOIs
Publication statusPublished - 1 Oct 2013
Externally publishedYes

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