A Feasibility Randomized Controlled Trial of Nurse-Led Screening-Based Early Care Program from the Time of Diagnosis for Patients with Advanced Lung Cancer and Their Caregivers.
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Abstract
Background: Although early palliative care (EPC) integrated into standard cancer care improves the quality of lives of patients with cancer and their caregivers, implementation strategies for EPC programs in individual clinical settings have not been established.
Objective: This pilot randomized controlled trial explored the feasibility, acceptability, and effectiveness of nurse-led EPC using a screening-based program that focused on the individual concerns of patients with advanced lung cancer and their caregivers.
Design: This pilot study was a parallel-group randomized controlled trial in which patients were randomly assigned (1:1) to receive either EPC using the care program or standard care alone.
Setting/subjects: At one university hospital in Japan, 32 patients with newly diagnosed stage IV lung cancer and their 27 caregivers participated.
Measurements: Feasibility was evaluated using recruitment and interview execution rates. Acceptability and effectiveness of the care program were also evaluated.
Results: The recruitment rate was 91%. The interview execution rates were 14/14 (100%) at baseline, 11/14 (79%) at 1 month, and 12/14 (86%) at 3 months for patients, and 10/11 (91%) at baseline, 6/11 (55%) at 1 month, and 7/11 (64%) at 3 months for caregivers. At 5 months, 55% of patients in the intervention group responded that the delivered care was valuable, while 88% of caregivers in the same group answered that it was valuable. The prevalence of severe concerns in patients and caregivers in the intervention group decreased after 1 month.
Conclusions: This pilot randomized controlled trial revealed that EPC using a screening-based program that focused on individual concerns in patients with advanced lung cancer and their caregivers was feasible and acceptable.
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