Evidence map›Paper›PMID 34044840›Full record

ArticleBMC health services research2021

Care plus study: a multi-site implementation of early palliative care in routine practice to improve health outcomes and reduce hospital admissions for people with advanced cancer: a study protocol.

Jennifer Philip, Roslyn Le Gautier, Anna Collins, Anna K Nowak, Brian Le, Gregory B Crawford, Nicole Rankin, Meinir Krishnasamy, Geoff Mitchell, Sue-Anne McLachlan and 5 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Characteristics of patients diagnosed with pancreatic cancer who access palliative care: An observational study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023
    Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Jennifer PhilipDepartment of Medicine, University of Melbourne, Melbourne, Australia.
Roslyn Le GautierDepartment of Medicine, University of Melbourne, Melbourne, Australia. Roslyn.legautier@unimelb.edu.au.ORCID http://orcid.org/0000-0002-4012-4126
Anna CollinsDepartment of Medicine, University of Melbourne, Melbourne, Australia.
Anna K NowakMedical School, University of Western Australia and Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Australia.
Brian LePalliative Care Service, Royal Melbourne Hospital, Melbourne, Australia.
Gregory B CrawfordNorthern Adelaide Local Health Network, Modbury Hospital, Adelaide, Australia.
Nicole RankinFaculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Meinir KrishnasamyDepartment of Nursing and Centre for Cancer Research, University of Melbourne, Melbourne, Australia.
Geoff MitchellSchool of Medicine, University of Queensland, Brisbane, Australia.
Sue-Anne McLachlanDepartment of Medicine, University of Melbourne, Melbourne, Australia.
Maarten IJzermanCancer Health Services Research, University of Melbourne, Melbourne, Australia.
Robyn HudsonSafer Care Victoria, Victoria State Government, Melbourne, Australia.
Danny RischinDepartment of Medicine, University of Melbourne, Melbourne, Australia.
Tanara Vieira SousaCentre for Health Policy, Health Economics Unit, University of Melbourne, Melbourne, Australia.
Vijaya SundararajanDepartment of Medicine, University of Melbourne, Melbourne, Australia.

Funding

National Health and Medical Research Council APP1174028
6 · The paper itself

Abstract

backgroundCurrent international consensus is that 'early' referral to palliative care services improves cancer patient and family carer outcomes. In practice, however, these referrals are not routine. An approach which directly addresses identified barriers to early integration of palliative care is required. This protocol details a trial of a standardized model of early palliative care (Care Plus) introduced at key defined, disease-specific times or transition points in the illness for people with cancer. Introduced as a 'whole of system' practice change for identified advanced cancers, the key outcomes of interest are population health service use change. The aims of the study are to examine the effect of Care Plus implementation on (1) acute hospitalisation days in the last 3 months of life; (2) timeliness of access to palliative care; (3) quality and (4) costs of end of life care; and (5) the acceptability of services for people with advanced cancer.

methodsMulti-site stepped wedge implementation trial testing usual care (control) versus Care Plus (practice change). The design stipulates 'control' periods when usual care is observed, and the process of implementing Care Plus which includes phases of planning, engagement, practice change and evaluation. During the practice change phase, all patients with targeted advanced cancers reaching the transition point will, by default, receive Care Plus. Health service utilization and unit costs before and after implementation will be collated from hospital records, and state and national health service administrative datasets. Qualitative data from patients, consumers and clinicians before and after practice change will be gathered through interviews and focus groups. DISCUSSION: The study outcomes will detail the impact and acceptability of the standardized integration of palliative care as a practice change, including recommendations for ongoing sustainability and broader implementation.

trial registrationAustralian New Zealand Clinical Trials Registry ACTRN 12619001703190 . Registered 04 December 2019.

Indexed as

NeoplasmsPalliative CareAustraliaClinical Trials as TopicHospitalizationHospitalsHumansOutcome Assessment, Health CareState MedicineHealth servicesImplementationIntegrated carePalliative care

Identifiers

PMID34044840
PMCPMC8157619

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.