Integrated Care Planning for Cancer Patients: A Scoping Review

Anum Irfan Khan; Erin Arthurs; Sharon Gradin; Marnie MacKinnon; Jonathan Sussman; Vishal Kukreti

doi:10.5334/ijic.2543

Figures & Tables

Table 1

Key stages and procedures used in conducting this scoping review.

Stage	Description
1. Clarifying purpose and identifying research questions	• Key research questions were shared with the expert panel and questions were refines to balance breadth with feasibility
2. Identifying relevant studies	• Development and refinement of search strategies and selection of databases
• Testing and refinements of inclusion and exclusion criterion for screening
3. Study selection	• Independent application of screening criterion at two levels – title and abstract review and full article review by two reviewers (AIK and EA)
• Resolution of disagreements by a third reviewer (VK) to determine final inclusion/exclusion
4. Data extraction	• Development, testing and application of the data extraction tool
5. Data analysis	• Summarizing descriptive characteristics of included articles
• Thematic analysis of extracted data and assessing the implications of findings for future research and policy changes
6. Consultation with key stakeholders	• Development of a knowledge translation strategy to share the overall conceptual framework and findings with a broad group of stakeholders and experts for further validation

Overview of article retrieval, screening and data extraction stages.

Table 2

Descriptive features of included articles.

Descriptive characteristics	Total (n = 67)	Relevant articles
Type
Surgical	28 (41.8%)	[34 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62]
Survivorship	24 (35.8%)	[32 35 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84]
Palliative	9 (13.4%)	[85 86 87 88 89 90 91 92 93]
Comprehensive	5 (7.5%)	[94 95 96 97 98]
Systemic	1 (1.5%)	[99]
Disease sites
Breast	18 (26.9%)	[35 45 63 65 66 67 68 69 72 73 77 79 82 83 84 95 96 98]
All	11 (16.4%)	[75 81 85 86 87 88 89 90 91 92 93]
Esophagus	7 (10.4%)	[37 47 48 49 50 52 97]
Colorectal	5 (7.5%)	[41 43 46 64 80]
Multiple¹	3 (4.4%)	[32 76 78]
Prostate	4 (6.0%)	[44 58 62 94]
Head and Neck	4 (6.0%)	[34 36 54 61]
Gynecological²	5 (7.5%)	[57 60 70 71 74]
Gastric, Bladder, Lung, Pancreatic, Brain, Larynx, and Testicular	10 (14.9%)	[38 39 40 42 51 53 55 56 59 99]
Country
USA	27 (40.3%)	[35 50 51 52 53 54 55 56 57 58 59 60 61 62 73 74 75 76 77 78 79 80 81 82 83 84 93]
UK	7 (10.4%)	[46 47 48 49 72 92 98]
Canada	7 (10.4%)	[34 36 37 38 65 66 67]
Netherlands	4 (6.0%)	[70 71 88 89]
Germany	4 (6.0%)	[39 40 68 69]
Denmark, Italy, Australia, Singapore, Belgium, China, Japan, Spain, Sweden, Taiwan, Turkey and Multiple³	18 (26.9%)	[32 41 42 43 44 45 63 64 85 86 87 90 91 94 95 96 97 99]
Medium
Paper	21 (31.3%)	[38 39 47 49 55 57 59 60 61 62 65 71 74 75 78 80 82 83 85 98 99]
Combination	10 (14.9%)	[34 35 64 66 70 73 76 77 79 81]
Electronic	6 (9.0%)	[32 44 52 63 93 95]
Unclear	30 (44.8%)	[36 37 40 41 42 43 45 46 48 50 51 53 54 56 58 67 68 69 72 84 86 87 88 89 90 91 92 94 96 97]
Study design
Prospective observational (no control)	25 (37.3%)	[35 41 50 52 53 56 58 62 63 64 66 72 73 75 76 77 78 79 80 84 95 96 97 98 99]
Pre and post comparison (with control)	21 (31.3%)	[34 36 37 38 39 42 43 44 45 47 48 49 51 55 57 60 61 86 88 91 93 94]
Prospective observational (with control)	13 (19.4%)	[46 50 53 54 59 69 81 82 85 89 90 92 95]
Randomized control trial	8 (11.9%)	[40 65 67 68 70 71 74 87]

[i] ¹Includes two or more disease sites;

²Includes ovarian, cervical, vaginal and/or endometrial cancer;

³The integrated care plan was implemented in multiple countries simultaneously.

Integrated care planning for cancer care framework.

Table 3

Overview of measurement tools used to assess the impact of Integrated Care Plans.

Indicators	Measurement tool/instrument
PATIENT
Quality of life	• Short Form 36 Questionnaire [45]
Quality of life	• Short Form 12 [46]
• European Organization for Research and treatment of Cancer Quality-of-life questionnaire [46 64]
Patient satisfaction	• Medical Outcomes Study – Patient Satisfaction Questionnaire [65]
• System Usability Scale (modified) [80]
Anxiety/distress	• Spielberger State-Trait Anxiety Inventory [45]
	• Brief Symptom Inventory [64]
	• Cancer Survivors Unmet Needs Scale [64]
	• Impact of Events Scale [65]
• Profile of Mood States [65]
• Distress Thermometer [71]
• Patient-Perceived Coordination Index [94]
• Hospital Anxiety and Depression Scale [72]
Caregiver-reported outcomes	• Toolkit After-Death Family Member Interview [86]
Caregiver-reported outcomes	• Views of Informal Carers Evaluation of Service Survey [86,88)
• Evaluating Care and Health Outcomes for the Dying [92]
• Family Satisfaction Survey [93]
PROVIDER
Uptake	• Chart reviews/retrospective audit [93]
Workflow – Time to complete care plan	• Provider self-report [80]
Provider satisfaction	• Telephone interviews [86 93]
Provider satisfaction	• System Usability Scale (modified) [80]
• Consumer Assessment of Healthcare Providers and Systems Adult Specialty Care Clinician Questionnaire (modified) [80]
SYSTEM*
Length of stay	• Number of nights spent in the hospital after surgery
Post-operative complications	• Post-operative complication rates
Mortality	• In-hospital mortality
Readmissions	• Hospital readmissions
Costs	• Total costs of hospital stay
Costs	• Total cost of delivering the plan
• Cost-effectiveness (i.e., quality adjusted life years gained for cost incurred)

[i] *Since most system-level indicators represent standardized metrics individual references are not provided.

Integrated Care Planning for Cancer Patients: A Scoping Review

Figures & Tables

Table 1

Figure 1

Table 2

Figure 2

Table 3

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