Findings from a Systematic Review on Cancer Care Coordinators (#132)
Aims: Cancer care coordinators have been implemented by a number of health services in an effort to overcome service fragmentation and improve patient and service outcomes, although the evidence is broad and poorly synthesised. This systematic review sought to examine the impact of these roles on patient care and outcomes and service delivery, from the perspective of patients, carers and clinicians.
Methods: We included articles with any study design published in English between 1990 and 2012 with adult patients with at least 70% of the sample diagnosed with cancer. Care coordination studies aiming to increase cancer screening or follow-up after abnormal test results were excluded. We searched MEDLINE, EMBASE, PubMed and other databases for published and unpublished studies.
Results: We included 59 studies from 72 articles involving 23,750 participants; this included 11 randomised controlled trials. Thirty-seven studies included in this review (n=9,107 patients) evaluated patient-reported outcomes, including quality of life, psychological morbidity, symptoms, concerns, self-efficacy, continuity of care, satisfaction with care and satisfaction with the care coordinator. In a qualitative synthesis, no impact on patient-reported outcomes of care coordination was found, with the exception of satisfaction with care, which was shown by most studies to increase with coordination, and satisfaction with the care coordinator, which was high among coordinated groups.
Conclusions: The cumulative evidence suggests cancer care coordination is associated with higher satisfaction with care, although evidence for other outcomes is inconclusive. Studies included varied significantly in design, setting and cancer population, and studies used a diverse range of (frequently non-validated) measurement tools.
Funding: Cancer Council Victoria’s Clinical Network