Poster with mini oral Clinical Oncology Society of Australia 2014 Annual Scientific Meeting

I-COPE: Pilot testing an innovative model of supportive and palliative care for patients with high grade glioma and their carers (#356)

Anna Collins 1 , Michael Murphy 2 , Michelle Gold 3 , Vijaya Sundararajan 4 , Caroline Brand 5 , Carrie Lethborg 6 , Anthony Dowling 7 , Gaye Moore 8 , Jane Staker 9 , Jennifer Philip 10
  1. Centre for Palliative Care, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
  2. Department of Neurosurgery, St Vincent's Hospital Melbourne, Fitzroy
  3. Palliative Care Service, Alfred Hospital, Melbourne, VIC, Australia
  4. Department of Medicine, St Vincent's Hospital & University of Melbourne, Fitzroy, VIC, Australia
  5. Melbourne EpiCentre, University of Melbourne & Melbourne Health, Parkville, VIC, Australia
  6. Social Work Department, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
  7. Department of Medical Oncology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
  8. Department of Psychiatry, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
  9. Department of Neurosurgery, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
  10. Centre for Palliative Care, St Vincent's Hospital, Melbourne, VIC, Australia

Aims: This study aims to conduct a pilot implementation and evaluation study of an innovative model (I-CoPE) designed to support patients with newly diagnosed high-grade glioma and their carers. I-CoPE involves the provision of staged information, coordination, preparation through regular screening, and emotional support based upon stages reached in the illness course.

Method: Design: Pilot implementation and program evaluation study of a complex intervention for patients with high grade malignant glioma and their carers. At key timepoints, routine screening and provision of structured information will occur, including: 1) During diagnosis admission; 2) Prior to commencing chemo-radiotherapy; 3) Completion of chemo-radiotherapy. Outcomes of interest: (1) Acceptability and feasibility: enrolment and retention rates, screening and referral outcomes, health service utilization data (summarised by descriptive statistics); (2) Patient and carer outcomes: psychological distress, unmet supportive care and information needs, quality of life, satisfaction with care and preparedness to care (change from baseline to post-intervention assessed using paired sample t tests (p <.05)). 

Results: I-CoPE is an acceptable and feasible intervention, with 95% enrolment rate of eligible patients (n=24) and their carers (n=20). Post I-CoPE: (1) Patients reported fewer unmet supportive care (d= 2.7, p <0.001) and information (d= 0.8, p=.06) needs and improved brain-cancer specific quality of life (d= 0.8, p=.05). (2) Carers reported fewer unmet supportive care (d= 1.0, p=.01) and information (d= 0.6, p=.08) needs, improved quality of life (d= 0.7, p=.08), lower carer burden (d= 1.1, p=.0009), and increased preparedness to care (d= 0.7, p=.06).

Conclusions: The positive preliminary results of this pilot implementation of the I-CoPE model into a tertiary neuro-oncology service - both in terms of feasibility and short-term efficacy with improved patient and carer reported outcomes - show promise for further testing via a randomised controlled trial and the potential for broader dissemination.