The overall aim of this project is to deliver better health care services through improved coordination of cancer care within specialist care (at the local hospital Orkdal Hospital) and community care (13 municipalities in the Orkdal region, Norway), and between these two levels in the health care system. "The Orkdal model" is developed and will be implemented and evaluated within cancer care. Cancer patients living in one of the 12 municipalities participating in the formal collaboration "Samhandlingsenheten i Orkdalsregionen" (SIO), or the municipality of Oppdal, having metastatic and/or loco-regional disease will be included in the study. Carers and health care providers will be included as well. Results from this project will be transferable to other parts of Norway and/or to other countries as well as to patients with other diagnoses causing complex conditions, such as chronic heart-, lung- and neurological disease.
This study will be a prospective controlled observational pre-post study. The intervention consists of three parts: a standardised care pathway, an educational programme and information to general public, patients and their carers. Data from patients, carers and health care providers (physicians, nurses and nurse assistants) will be collected before the model is implemented (pre-intervention part) and after final implementation (post-intervention part). In addition, a comparison with a similar patient population, carers and health care providers will be conducted. A local hospital in the county of Romsdal and community care in the same region will be used as control. Added January 2020: The study was in 2018 extended to also evaluate the effect of implementing "advance care planning" in the county of Møre and Romsdal. Møre and Romsdal started implementation of "advance care planning" in January 2018. The evaluation of "advance care planning in Møre and Romsdal" has the same endpoints as the evaluation of the Orkdal model trial. Added December 17th, 2021: Inclusion of participants (patients, carers and healthcare professionals) is from Sept 2018 to March 2021. Follow-up ends in Sept. 2022.
Study Type
OBSERVATIONAL
Enrollment
969
a standardised care pathway, an educational programme and information to general public, patients and their carers
Agdenes community care
Agdenes, Norway
Aukra community care
Aukra, Norway
Eide community care
Eide, Norway
Fræna community care
Fræna, Norway
Frøya community care
Frøya, Norway
Halsa community care
Halsa, Norway
Hemne community care
Hemne, Norway
Hitra community care
Hitra, Norway
Meldal community care
Meldal, Norway
Midsund community care
Midsund, Norway
...and 15 more locations
proportion of patient's time spent at home the last 3 months of life
time in days
Time frame: 3 years
carers' health related quality of life (HRQOL) 6 months after patient's death
as measured by the total score of the RAND-Short Form-36
Time frame: 3 years
Number of home deaths
Time frame: 3 years
Use of tumor directed treatment the last 3 months of life
radiotherapy and chemotherapy
Time frame: 3 years
change over time in health care providers' knowledge and skills
Time frame: 3 years
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