The Better Living Programme: improving cancer care in rural settings
Robert Wedel, Tobias Gelber, Melissa Wilde, Leanne Popson-Esau, Carmen Thompson, Neil Drummond
Carmen Thompson at firstname.lastname@example.org, 403.210.9259
Alberta Health Services - Cancer Care, Community Cancer Support Network
Alberta Cancer Foundation
Canadian Cancer Society, Alberta / N.W.T. Divison
Manuscript In Development
Rural cancer patients often find themselves dislocated from their families and communities, and isolated by virtue of the distances and travel involved in obtaining specialized treatment. These patients also tend to lose contact with their family doctor and primary care team, their “Medical Home.” The Better Living Programme (BLP) is designed to improve quality of life, access, continuity of care, and to reduce cancer-associated morbidity and hospital and Emergency Department admissions, for patients with an active or new diagnosis of colon, prostate, breast, or lung cancer. The intervention involves proactive surveillance by the patient’s family practice team and the development of an individualized complex care plan that includes patient and provider identified goals, addresses psycho-social, spiritual and medical needs, and supports multidisciplinary involvement in care.
This study employs a non-randomized, quasi-experimental research design to evaluate the impact of the BLP on: (1) patient quality of life, (2) continuity of care, (3) caregiver quality of life, (4) ER and acute care admissions, and (5) patient satisfaction.
PARTICIPANTS: Patients with an active or new diagnosis of colon, breast, prostate, or lung cancer participating in the Better Living Programme through a primary care clinic in a rural community in Southern Alberta, as well as a control or usual care group recruited from a comparable clinic within the same geographic area. All patients will identify one family member or significant friend, judged as having the most practical involvement in their day-to-day lives, for participation in the research.
MEASURES: Patients will complete screening for distress, quality of life and satisfaction questionnaires at months 6 and 12 of the intervention. Caregivers will complete a quality of life questionnaire at the same intervals, and health professional staff will complete a questionnaire regarding their perceptions of the intervention, at the 12 months. Data analysis will involve chi-square and t-tests comparing the two clinics, with possible sub-analyses exploring outcomes for different cancers or demographic groups.