Objectives A prospective cohort study to evaluate clinical effectiveness of the enhanced supportive care (ESC) service at a comprehensive cancer centre and to explore the impact of the service on patient and caregiver outcomes and experience.
Methods Patients who received care under the ESC service and their caregivers were eligible. Consented patients (n=184) and caregivers (n=67) completed questionnaires at baseline, 4 weeks and 8 weeks post-ESC. Patient questionnaires assessed quality of life (QOL), symptoms, experience of ESC and health service use. Caregiver questionnaires included QOL and needs assessment. Selected patients (n=13) participated in qualitative interviews. Quantitative analysis explored differences in questionnaire responses over time (p<0.05). Qualitative data were analysed thematically.
Results Patient quantitative data showed improvements in QOL (p=0.004 for European Quality of Life Questionnaire 5 dimensions (EQ5D) health index scores) and anxiety (p=0.006) at 4 weeks, reduction in some symptoms (pain p=0.02 at 4 weeks), improvement in self-efficacy, an increase in problems being addressed and a decrease in health service use (reduction in outpatient appointments). Qualitative findings suggested patients were generally satisfied with the ESC service but identified areas for improvement such as increased awareness of ESC and earlier referral. Fewer improvements were noted for caregivers; however, they did report a decrease in unmet needs.
Conclusion The ESC service had a positive impact on various patient-reported and caregiver-reported outcomes. There were also positive impacts on health service use. Increasing awareness of ESC and engaging patients at an earlier stage in the disease trajectory may further improve patient satisfaction and outcomes.
- Quality of life
- Supportive care
- Symptoms and symptom management
Data availability statement
No data are available. In order to protect participants' privacy, data cannot be shared.
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Contributors ST: conception of the work, analysis and interpretation of the data, drafting and revising the manuscript, final approval of the manuscript; guarantor. AV: acquisition of data, revising the manuscript, final approval of the manuscript. CS: conception of the work, acquisition of data. revising the manuscript, final approval of the manuscript. BK: acquisition of data, revising the manuscript, final approval of the manuscript. JC-M: acquisition of data, revising the manuscript, final approval of the manuscript. JY: conception of the work, revising the manuscript, final approval of the manuscript. CM: conception of the work, revising the manuscript, final approval of the manuscript. RB: conception of the work, revising the manuscript, final approval of the manuscript.
Funding This study was funded by the Pain and Symptom Charitable Fund at The Christie NHS Foundation Trust.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.