Skip to main content

Table 5 Summary of planned alterations to improve the success of the study

From: Improving management of comorbidity in patients with colorectal cancer using comprehensive medical assessment: a pilot study

Issue Solution
Improved recruitment numbers Investigate a service level intervention whereby individual patients are not recruited, i.e. a clustered roll out across multi-centres
Enact the strategies used within this pilot study e.g. workshops and meetings at regular intervals, identify local clinical champions, but allow a longer lead-in time for each centre before they are recruited into the study
Have clear accountability for recruitment numbers to the study team
Increase the number of potentially eligible participants by including a wider range of cancer types
Have three defined points at which patients are recruited 1) pre-elective surgery outpatient clinics as part of standard care, 2) at pre-operative MDM, and 3) at point or referral to medical oncology assessment, if not already recruited at point 1) or 2)
Pre-operative recruitment and CMA Include pre-operative recruitment as a study criteria with allowance for point 3) above
Develop processes so that the CMA intervention is delivered pre-operatively
Variability observed between the patient groups minimised Ensure mechanisms are in place to ensure balanced invitation processes e.g. randomisation of services (using a cluster approach) and/or recruitment of consecutive patients over a defined period
Screening tool with greater specificity Carry out a literature review and iterative design of a screening tool applicable for the NZ context
Intervention modified to better integrate into clinical pathways Consider other models of intervention e.g. CMA carried out by cancer specialist nursing, surgical or oncology team with referrals as needed; CMA carried out and oncology team provided with results to take necessary action; primary care practitioner provided with results to take necessary action
Screening tool and intervention well accepted and used in practice Provide patients with more information about the intervention at point-of-referral
Enable participatory research approaches with key hospital staff including clinicians, nursing, service managers