Care After Lymphoma (CALy) trial: A phase II pilot pragmatic randomised controlled trial of a nurse-led model of survivorship care

Eur J Oncol Nurs. 2019 Jun:40:53-62. doi: 10.1016/j.ejon.2019.03.005. Epub 2019 Mar 27.

Abstract

Purpose: Post-treatment follow-up for lymphoma potentially fails to address the supportive care needs of survivors. A nurse-led lymphoma survivorship model of care was developed and tested in a phase II pilot pragmatic randomised controlled trial (RCT). The intervention comprised three face-to-face appointments, delivery of tailored resources and an individualised survivorship care plan and treatment summary (SCPTS), shared with the general practitioner (GP).

Method: Three months' post-treatment completion, eligible lymphoma patients were randomised 1:1 to usual care (control) or usual care plus intervention. Survivorship unmet needs (Short-Form Survivor Unmet Needs Survey), distress (Depression Anxiety Stress Scale 21), adjustment to cancer (Mini-Mental Adjustment to Cancer scale) and self-empowerment (Patient Empowerment Scale) were assessed at baseline, three and six months. Univariate and multivariate analyses examined changes within and between groups at the three time points. A GP evaluation survey sought information on the perceived utility of the SCPTS.

Results: Statistical significance was set at 0.05 (2-tailed). Although not statistically significant, by study completion, intervention participants (n = 30), reported less unmet needs (M = 21.41 vs M = 25.72, p = .506), less distress ((M = 13.03 vs M = 15.14, p = .558) and an increase in empowerment (M = 50.21 vs M = 47.21, p = .056) compared with control participants (n = 30). The SCPTS was rated good to very good by a majority of GPs (n = 13, 81%).

Conclusions: The nurse-led lymphoma survivorship model of care may be a helpful intervention for lymphoma patients who had completed treatment. Survivors require individualised and tailored support and resources. A tailored SCPTS may promote survivor self-management and increase GP engagement.

Keywords: Lymphoma; Nurse-led model of care; Randomised controlled trial; Survivorship.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aftercare / organization & administration*
  • Aged
  • Aged, 80 and over
  • Cancer Survivors / psychology*
  • Cancer Survivors / statistics & numerical data
  • Female
  • Health Care Surveys
  • Health Services Needs and Demand
  • Humans
  • Lymphoma / nursing*
  • Lymphoma / psychology
  • Male
  • Middle Aged
  • Models, Nursing*
  • Nursing Evaluation Research
  • Pilot Projects
  • Power, Psychological
  • Practice Patterns, Nurses'*
  • Self-Management / psychology
  • Young Adult