Table 4.

Randomised controlled trial details and study outcomes

Study author	Participants (n), type of cancer, stage of cancer care continuum	Description of study	Results
Bergholdt et al, 2013, Denmark22	n=955 patients (baseline); 612 patients (6-month follow-up); 506 patients (14-month follow-up); 776 GPs (14-month follow-up) Any type of cancer was considered; Treatment into survivorship	Intervention: (CM) Assessment of patient needs; results shared with patients’ GPs, who were then encouraged to contact patients to facilitate rehabilitation Control: Standard care Data collection methods: Self-administered questionnaires Outcome(s) measured: Patients’ satisfaction with their GPs (in general) and with GP support, and GPs’ satisfaction with their contribution to their patients’ well-being	No statistically significant effects of the intervention were observed. Subgroup analysis of breast cancer patients showed a statistically significant improvement of satisfaction with their GP, in regards to ‘information and support’ and ‘the organisation of care’.
Grunfeld et al, 2011, Canada23	n=407 patients (baseline); 332 patients (3-month follow-up); 318 patients (6-month follow-up); 299 (12-month follow-up) Breast; Survivorship	Intervention: (SCPs) Supplement to standard care; all routine follow-up care transferred to patients’ PCPs, and SCPs sent to patients and their PCPs Control: Enhanced standard care (ie, all routine follow-up care transferred to patients' PCPs) Data collection methods: Self-administered questionnaires and collection of health services records Outcome(s) measured: Patients’ level of cancer-related distress, quality of life, patient satisfaction, continuity of care, and health services outcomes (ie, patient transfer to PCP, oncologist visits, and awareness of which care provider is primarily responsible for follow-up care).	No statistically significant effects of the intervention were observed on any outcome measure, at any time point. Nine intervention and five control patients were not transferred to the PCP for follow-up due to recurrence/other reasons. After transfer to PCP, 16 control patients and 15 intervention patients visited an oncologist. Overall, over 89% of patients correctly identified their PCP as being the primary provider of follow-up care; at 12 months, significantly more intervention group patients were able to do so.
Johnson et al, 2015, Australia24	n=88 patients; 55 PCPs; 5 cancer specialists Haematological, breast, ovarian and colorectal cancers; Treatment	Intervention: (CM) Shared care model, incorporating the use of patient-held records and dissemination of PCP educational resources packages Control: Standard care Data collection methods: Self-administered questionnaires and symptom diary completion Outcome(s) measured: Patients’ level of anxiety, depression, empowerment, adverse effects of treatment and patients’, PCPs' and cancer specialists’ perceptions of the shared care model	No statistically significant differences in patients’ levels of anxiety, depression, empowerment or adverse effects of treatment were observed. No differences were detected in perceptions of care between PCPs and patients in the intervention and control groups. The majority (88%) of PCPs found the patient health records to be useful and the majority of their comments were positive. One of five cancer specialists thought the patient health record was useful and all five had concerns about the shared care model.
King et al, 2009, UK25	n=93 patients (baseline); 61 patients (6-month follow-up) Breast, colorectal and lung; Treatment into survivorship	Intervention: (CM) (a) Patients completed continuity assessment; (b) Patients completed aforementioned assessment; results shared with clinical nurse specialists, who were encouraged to address patients’ needs Control: Standard care Data collection methods: Self-administered questionnaires Outcome(s) measured: Patients’ experienced continuity of care	No statistically significant differences in patients’ experienced continuity of care; some trends were observed. For example, participants in the intervention trial arms expressed less unmet needs for care than participants allocated to the control group.
Wagner et al, 2014, USA26	n=251 patients (baseline); 242 patients (4-month follow-up); 229 patients (12-month follow-up) Breast, colorectal and lung; Diagnosis into treatment	Intervention: (Nurse navigation) Four months of nurse navigation support Control: Enhanced standard care (ie, receipt of more tailored patient education) Data collection methods: Telephone-administered questionnaires and automated administrative data Outcome(s) measured: Quality of life, patient experience with care, healthcare costs	There were no statistically significant differences between intervention and control groups in quality of life scores. Nurse navigator patients reported a significantly higher extent to which care actively involves patients, and reported significantly fewer problems with care (especially regarding psychosocial care, care coordination, and information). Furthermore, there were no statistically significant differences (by cancer type and intervention group) in the median cumulative costs of care, calculated from 3 months before the date of diagnosis through to 1 year postdiagnosis.
Wulff et al, 2013, Denmark27	n=280 GPs (baseline); 228 GPs (30 weeks) Colorectal; Primarily diagnosis into treatment	Intervention: (Hospital-based CM) Supplement to standard care, involving assessment of patient needs, patient outreach and informing GPs of patients’ overall health status Control: Standard care Data collection methods: Self-administered questionnaires and Danish National Health Service Register Outcome(s) measured: GPs’ evaluation of the intervention, and amount of contact between patients and GPs during daytime hours and out-of-hours services	The use of CM was associated with a significant tendency towards more positive evaluations (particularly relating to psychological effects of the cancer, social effects of the cancer and information given to the patient by the specialists). Additionally, significantly fewer CM GPs than non-CM GPs reported having contacted the hospital regarding their patients’ care. CM did not affect the number of patient contacts with their GPs during daytime hours, but CM patients showed a tendency towards more contacts to out-of-hours GP services than non-CM patients.

The recorded number of participants in the second column of the table represents the number that completed the study at each time point.

CM, case management; GP, general practitioner; PCP, primary care provider; RCT, randomised controlled trial; SCP, survivorship care plan.