Evaluation of Cancer Care Coordination in the National Cancer Institutes Community Cancer Center Programs
Condition: Non-Small Cell Lung Cancer (Stage III); Colon Cancer (Stage II &Amp; III); Rectal Cancer (Stage III)
MeSH terms: Carcinoma, Non-Small-Cell Lung; Rectal Neoplasms; Colonic Neoplasms
Study type: Observational

Summary: 
      Background:

      -Coordinated cancer care provided by doctors, nurses, social workers, and other care
      providers is believed to improve patient and physician satisfaction and patient evaluation
      for enrollment in clinical trials. But no research has been done to show that this approach
      improves patient experiences and outcomes. Researchers want to study this model to better
      understand how it can improve cancer treatment and patient outcomes.

      Objectives:

      - To assess the relationship between coordinated care and cancer treatment processes and
      outcomes.

      Eligibility:

      - Individuals who are at least 18 years of age. Those who take part must have been diagnosed
      with colon, rectal, or non-small-cell lung cancer. They also must be receiving or have been
      treated at one of the 16 NCI Community Cancer Center program sites.

      Design:

        -  Researchers will collect medical records data from participants.

        -  Participants will complete a questionnaire about 8 weeks after the end of all planned
           cancer treatment. They will be asked questions about their experience with coordinated
           cancer care. They will also be asked for any comments or concerns they had during and
           after treatment.

        -  No treatment or additional tests will be provided as part of this protocol.
    

Detailed description: 
      There is little evidence regarding the effect of multidisciplinary care (MDC) on health
      outcomes across various cancer sites, including colon, rectal, and lung cancer. The current
      study addresses this gap by providing preliminary data regarding the relationship between MDC
      and selected processes and outcomes of care in NCCCP pilot sites. The long-term goal of this
      preliminary study is to generate effect sizes, establish feasibility, and build
      infrastructure to support the development of a larger more definitive study of MDC outcomes.
      The key aim of this pilot study is to determine the relationship between specific MDC
      assessment areas identified by a pre-existing MDC assessment tool (http://ncccp .cancer.gov
      /NCCCPMDC- Matrix- Tool. pdf ): case planning, physician engagement, coordination of care,
      infrastructure, financial, clinical trials and medical records, and each of the following
      outcomes [0] and processes [P]: 1) time to receipt of initial therapy[P]; 2) receipt of
      multi-modality therapy[O]; 3) evaluation for enrollment in a clinical trial[P]; 4) patient
      experience[O]; 5) adherence to NCCN treatment guidelines[P]; and 6) all-cause survival[O].
      The study focuses on adult patients with an incident diagnosis of Stage III colon cancer,
      Stage II or III rectal cancer, or Stage III non-small cell lung cancer.

      We will quantify the relationship between MDC, various care processes and outcomes across 16
      participating NCCCP sites, testing the hypothesis that increasing levels of MDC identified by
      the MDC tool are associated with improvement in care quality and a survival advantage.

      Significant progress has been achieved in the past year establishing the necessary

      processes for conducting the research study and the deliverables associated with the study.
      In terms of process outcomes, we can report the following:

        1. Institutional Review Board approval for the multidisciplinary care study at all 16

           sites;

        2. The development of a Standard Operating Procedures manual for use by the 16 sites;

        3. The development of a data collection form (Site Data Collection Tool) to be used for

           collecting information that is not available via the pre-existing web-based data

           collection system that is in place at the 16 sites;

        4. The development of a data collection form to be used for documenting the facility s

           annual scores using the Multidisciplinary Care Assessment tool.

        5. The development of a flowchart for use in operationalizing the measurement of

           NCCN guideline adherence for patients with Stage III non small cell lung cancer;

        6. The development of a Frequently Asked Questions document to assist with

           addressing questions in real time;

        7. Multiple training sessions/webinars have been held for the participating sites.

        8. Monthly conference call with the research team and representatives from all

      participating sites.
    

Time perspective: Other
Keywords: Adherence to Evidence-Based Guidelines; Multidisciplinary Care; Patient Experiences; Quality of Care Outcomes