Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial
Abstract Background Health service change is difficult to achieve. One strategy to facilitate such change is the clinical pathway, a guide for clinicians containing a defined set of evidence-based interventions for a specific condition. However, optimal strategies for implementing clinical pathways...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-018-4962-9 |
| _version_ | 1818506455108550656 |
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| author | Phyllis Butow Joanne Shaw Heather L. Shepherd Melanie Price Lindy Masya Brian Kelly Nicole M. Rankin Afaf Girgis Thomas F. Hack Philip Beale Rosalie Viney Haryana M. Dhillon Joseph Coll Patrick Kelly Melanie Lovell Peter Grimison Tim Shaw Tim Luckett Jessica Cuddy Fiona White The ADAPT Program Group |
| author_facet | Phyllis Butow Joanne Shaw Heather L. Shepherd Melanie Price Lindy Masya Brian Kelly Nicole M. Rankin Afaf Girgis Thomas F. Hack Philip Beale Rosalie Viney Haryana M. Dhillon Joseph Coll Patrick Kelly Melanie Lovell Peter Grimison Tim Shaw Tim Luckett Jessica Cuddy Fiona White The ADAPT Program Group |
| author_sort | Phyllis Butow |
| collection | DOAJ |
| description | Abstract Background Health service change is difficult to achieve. One strategy to facilitate such change is the clinical pathway, a guide for clinicians containing a defined set of evidence-based interventions for a specific condition. However, optimal strategies for implementing clinical pathways are not well understood. Building on a strong evidence-base, the Psycho-Oncology Co-operative Research Group (PoCoG) in Australia developed an evidence and consensus-based clinical pathway for screening, assessing and managing cancer-related anxiety and depression (ADAPT CP) and web-based resources to support it - staff training, patient education, cognitive-behavioural therapy and a management system (ADAPT Portal). The ADAPT Portal manages patient screening and prompts staff to follow the recommendations of the ADAPT CP. This study compares the clinical and cost effectiveness of two implementation strategies (varying in resource intensiveness), designed to encourage adherence to the ADAPT CP over a 12-month period. Methods This cluster randomised controlled trial will recruit 12 cancer service sites, stratified by size (large versus small), and randomised at site level to a standard (Core) versus supported (Enhanced) implementation strategy. After a 3-month period of site engagement, staff training and site tailoring of the ADAPT CP and Portal, each site will “Go-live”, implementing the ADAPT CP for 12 months. During the implementation phase, all eligible patients will be introduced to the ADAPT CP as routine care. Patient participants will be registered on the ADAPT Portal to complete screening for anxiety and depression. Staff will be responsible for responding to prompts to follow the ADAPT CP. The primary outcome will be adherence to the ADAPT CP. Secondary outcomes include staff attitudes to and experiences of following the ADAPT CP, using the ADAPT Portal and being exposed to ADAPT implementation strategies, collected using quantitative and qualitative methods. Data will be collected at T0 (baseline, after site engagement), T1 (6 months post Go-live) and T2 (12 months post Go-live). Discussion This will be the first cluster randomised trial to establish optimal levels of implementation effort and associated costs to achieve successful uptake of a clinical pathway within cancer care. Trial registration The study was registered prospectively with the ANZCTR on 22/3/2017. Trial ID ACTRN12617000411347 |
| first_indexed | 2024-12-10T22:04:50Z |
| format | Article |
| id | doaj.art-3e662d90a6454fd4b3f3512ed9faebf6 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-10T22:04:50Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-3e662d90a6454fd4b3f3512ed9faebf62022-12-22T01:31:47ZengBMCBMC Cancer1471-24072018-11-0118111210.1186/s12885-018-4962-9Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trialPhyllis Butow0Joanne Shaw1Heather L. Shepherd2Melanie Price3Lindy Masya4Brian Kelly5Nicole M. Rankin6Afaf Girgis7Thomas F. Hack8Philip Beale9Rosalie Viney10Haryana M. Dhillon11Joseph Coll12Patrick Kelly13Melanie Lovell14Peter Grimison15Tim Shaw16Tim Luckett17Jessica Cuddy18Fiona White19The ADAPT Program GroupPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyCollege of Nursing, Rady Faculty of Health Sciences, University of ManitobaCancer Services for the Sydney Local Health District (Incorporating Royal Prince Alfred, Concord and Canterbury HospitalsCentre for Health Economics Research and Evaluation, University of TechnologyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneySchool of Public Health, University of SydneyHammondCare Northern SydneyChris O’Brien LifehouseCharles Perkins Centre Faculty of Health Sciences, University of SydneyImproving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), University of Technology SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyPsycho-Oncology Co-operative Research Group (PoCoG), University of SydneyAbstract Background Health service change is difficult to achieve. One strategy to facilitate such change is the clinical pathway, a guide for clinicians containing a defined set of evidence-based interventions for a specific condition. However, optimal strategies for implementing clinical pathways are not well understood. Building on a strong evidence-base, the Psycho-Oncology Co-operative Research Group (PoCoG) in Australia developed an evidence and consensus-based clinical pathway for screening, assessing and managing cancer-related anxiety and depression (ADAPT CP) and web-based resources to support it - staff training, patient education, cognitive-behavioural therapy and a management system (ADAPT Portal). The ADAPT Portal manages patient screening and prompts staff to follow the recommendations of the ADAPT CP. This study compares the clinical and cost effectiveness of two implementation strategies (varying in resource intensiveness), designed to encourage adherence to the ADAPT CP over a 12-month period. Methods This cluster randomised controlled trial will recruit 12 cancer service sites, stratified by size (large versus small), and randomised at site level to a standard (Core) versus supported (Enhanced) implementation strategy. After a 3-month period of site engagement, staff training and site tailoring of the ADAPT CP and Portal, each site will “Go-live”, implementing the ADAPT CP for 12 months. During the implementation phase, all eligible patients will be introduced to the ADAPT CP as routine care. Patient participants will be registered on the ADAPT Portal to complete screening for anxiety and depression. Staff will be responsible for responding to prompts to follow the ADAPT CP. The primary outcome will be adherence to the ADAPT CP. Secondary outcomes include staff attitudes to and experiences of following the ADAPT CP, using the ADAPT Portal and being exposed to ADAPT implementation strategies, collected using quantitative and qualitative methods. Data will be collected at T0 (baseline, after site engagement), T1 (6 months post Go-live) and T2 (12 months post Go-live). Discussion This will be the first cluster randomised trial to establish optimal levels of implementation effort and associated costs to achieve successful uptake of a clinical pathway within cancer care. Trial registration The study was registered prospectively with the ANZCTR on 22/3/2017. Trial ID ACTRN12617000411347http://link.springer.com/article/10.1186/s12885-018-4962-9ImplementationClinical pathwaysCancerAnxiety and depressionCluster randomised controlled trialHealth services |
| spellingShingle | Phyllis Butow Joanne Shaw Heather L. Shepherd Melanie Price Lindy Masya Brian Kelly Nicole M. Rankin Afaf Girgis Thomas F. Hack Philip Beale Rosalie Viney Haryana M. Dhillon Joseph Coll Patrick Kelly Melanie Lovell Peter Grimison Tim Shaw Tim Luckett Jessica Cuddy Fiona White The ADAPT Program Group Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial BMC Cancer Implementation Clinical pathways Cancer Anxiety and depression Cluster randomised controlled trial Health services |
| title | Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial |
| title_full | Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial |
| title_fullStr | Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial |
| title_full_unstemmed | Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial |
| title_short | Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial |
| title_sort | comparison of implementation strategies to influence adherence to the clinical pathway for screening assessment and management of anxiety and depression in adult cancer patients adapt cp study protocol of a cluster randomised controlled trial |
| topic | Implementation Clinical pathways Cancer Anxiety and depression Cluster randomised controlled trial Health services |
| url | http://link.springer.com/article/10.1186/s12885-018-4962-9 |
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