Phase 0-1 early palliative home care cancer treatment intervention study

BMJ Support Palliat Care. 2022 May;12(e1):e103-e111. doi: 10.1136/bmjspcare-2018-001716. Epub 2019 May 8.

Abstract

Objectives: Recent studies have shown that the early provision of palliative care (PC) integrated into oncology in the hospital has beneficial effects on the quality of life of people who are dying and their family caregivers. However, a model to integrate palliative home care (PHC) early in oncology care is lacking. Therefore, our aim is to develop the Early Palliative Home care Embedded in Cancer Treatment (EPHECT) intervention.

Methods: We conducted a phase 0-1 study according to the Medical Research Council framework. Phase 0 consisted of a literature search on existing models for early integrated PC, and focus groups with PHC teams to investigate experiences with being introduced earlier. In phase 1, we developed a complex intervention to support the early integration of PHC in oncology care, based on the results of phase 0. The intervention components were reviewed and refined by professional caregivers and stakeholders.

Results: Phase 0 resulted in components underpinning existing interventions. Based on this information, we developed an intervention in phase 1 consisting of: (1) information sessions for involved professionals, (2) general practitioner as coordinator of care, (3) regular and tailored home consultations by the PHC team, (4) a semistructured conversation guide to facilitate consultations, and (5) interprofessional and transmural collaboration.

Conclusion: Taking into account the experiences of the PHC teams with being involved earlier and the components underpinning successful interventions, the EPHECT intervention for the home setting was developed. The feasibility and acceptability of the intervention will be tested in a phase II study.

Keywords: cancer; home care.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Focus Groups
  • Home Care Services*
  • Hospice and Palliative Care Nursing*
  • Humans
  • Neoplasms* / therapy
  • Palliative Care / methods
  • Quality of Life