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dc.contributor.authorHjermstad, Marianne Jensen
dc.contributor.authorAass, Nina Kathrine
dc.contributor.authorAndersen, Sigve
dc.contributor.authorBrunelli, Cinzia
dc.contributor.authorDajani, Olav
dc.contributor.authorAhmed, Herish
dc.contributor.authorHamre, Hanne Mari
dc.contributor.authorHaukland, Ellinor Christin
dc.contributor.authorHolmberg, Mats
dc.contributor.authorJordal, Frode
dc.contributor.authorKrogstad, Hilde
dc.contributor.authorLundeby, Tonje
dc.contributor.authorLøhre, Erik T
dc.contributor.authorMjåland, Svein
dc.contributor.authorNordbø, Arve
dc.contributor.authorPaulsen, Ørnulf
dc.contributor.authorStaff, Erik Schistad
dc.contributor.authorWester, Torunn
dc.contributor.authorKaasa, Stein
dc.contributor.authorLoge, Jon Håvard
dc.date.accessioned2020-06-24T10:15:52Z
dc.date.available2020-06-24T10:15:52Z
dc.date.issued2020-04-02
dc.description.abstract<p><i>Background - </i>Several publications have addressed the need for a systematic integration of oncological care focused on the tumor and palliative care (PC) focused on the patient with cancer. The exponential increase in anticancer treatments and the high number of patients living longer with advanced disease have accentuated this. Internationally, there is now a persuasive argument that introducing PC early during anticancer treatment in patients with advanced disease has beneficial effects on symptoms, psychological distress, and survival. <p><i>Methods - </i>This is a national cluster-randomized trial (C-RCT) in 12 Norwegian hospitals. The trial investigates effects of early, systematic integration of oncology and specialized PC in patients with advanced cancer in six intervention hospitals compared with conventional care in six. Hospitals are stratified on the size of local catchment areas before randomization. In the intervention hospitals, a three-part complex intervention will be implemented. The backbone of the intervention is the development and implementation of patient-centered care pathways that contain early, compulsory referral to PC and regular and systematic registrations of symptoms. An educational program must be completed before patient inclusion. A total of 680 patients with advanced cancer and one caregiver per patient are included when patients come for start of last line of chemotherapy, defined according to national treatment guidelines. Data registration, clinical variables, and patient- and caregiver-reported outcomes take place every 2 months for 1 year or until death. The primary outcome is use of chemotherapy in the last 3 months of life by comparing the proportion of patients who receive this in the intervention and control groups. Primary outcome is use of chemotherapy in the last 3 months before death, i.e. number of patients. Secondary outcomes are initiation, discontinuation and number of cycles, last 3 months of life, administration of other medical interventions in the last month of life, symptom burden, quality of life (QoL), satisfaction with information and follow-up, and caregiver health, QoL, and satisfaction with care. <p><i>Discussion - </i>Results from this C-RCT will be used to raise the awareness about the positive outcomes of early provision of specialized palliative care using pathways for patients with advanced cancer receiving medical anticancer treatment. The long-term clinical objective is to integrate these patient-centered pathways in Norwegian cancer care. The specific focus on the patient and family and the organization of a predictable care trajectory is consistent with current Norwegian strategies for cancer care.en_US
dc.identifier.citationHjermstad MJ, Aass NK, Andersen S, Brunelli C, Dajani O, Ahmed H, Hamre HM, Haukland E, Holmberg M, Jordal F, Krogstad H, Lundeby TL, Løhre ETL, Mjåland S, Nordbø A, Paulsen Ø, Staff Es, Wester T, Kaasa S, Loge JH. PALLiON - PALLiative care Integrated in ONcology: Study protocol for a Norwegian national cluster-randomized control trial with a complex intervention of early integration of palliative care. Trials. 2020;21:303:1-17en_US
dc.identifier.cristinIDFRIDAID 1812664
dc.identifier.doi10.1186/s13063-020-4224-4
dc.identifier.issn1745-6215
dc.identifier.urihttps://hdl.handle.net/10037/18645
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.journalTrials
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2020 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806en_US
dc.titlePALLiON - PALLiative care Integrated in ONcology: Study protocol for a Norwegian national cluster-randomized control trial with a complex intervention of early integration of palliative careen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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