Multi-centre randomized trial of centralised nurse-led telephone-based care coordination to improve outcomes following surgical resection of colorectal cancer: the ‘CONNECT’ intervention (#333)
This study investigated the effectiveness of a centralised, nurse-delivered telephone-based service to improve care coordination and patient outcomes in the six months following surgery for colorectal cancer.
Patients who had a resection for colorectal cancer were randomised to the CONNECT intervention or usual care. Intervention group patients received standardised calls from the centrally-based nurse on Days 3 and 10 and 1, 3 and 6 months after discharge from hospital. Control group patients received usual care. Experience of care coordination, unplanned readmissions and emergency department presentations, supportive care needs and quality of life (QOL) were assessed by questionnaire at 1, 3 and 6 months.
Of 775 patients recruited from 23 public and private hospitals in Australia, 387 were randomised to the intervention group and 369 to the control group. There were no significant differences between groups in unmet supportive care needs, but these were consistently low in both groups at all follow-up time points. There were small, non-significant reductions in the intervention group in the proportion of patients reporting an emergency department presentation (10.8% versus 13.8%, p=0.2) and unplanned hospital readmission (8.6% versus 10.5%, p=0.4) at 1 month. By 6 months, 25.6% of intervention group patients reported an unplanned readmission compared with 27.9% of controls (p=0.5). There were no differences in experience of care coordination, distress or quality of life between groups at any follow up time point.
This trial failed to demonstrate substantial benefit of a centralised system to provide standardised, telephone follow up for post-operative patients with colorectal cancer. Future studies could test a more targeted approach.