Enhancing Transsectoral Interdisciplinary Patient-Centered Care for Patients With Rare Cancers: Protocol for a Mixed Methods Process Evaluation

JMIR Research Protocols · 7 authors, 6 centres

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TL;DR

This paper outlines the protocol for a mixed methods process evaluation of a complex intervention designed to improve coordination and patient-centered care for patients with rare cancers in the German health care system. The evaluation aims to assess intervention fidelity, implementation processes, and contextual factors.

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The paper describes the protocol for a mixed methods process evaluation of the 'Trans-sectoral Personalised Care Concept for Patients with Rare Cancers' intervention. The evaluation seeks to understand intervention fidelity, intended and unintended effects, and barriers to implementation. The evaluation will help interpret the intervention's results and inform future adaptations. Data collection began in March 2023, with recruitment expected to end in September 2025.

STUDY TYPE

other

SPECIALTY

oncology

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AI pipeline

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ORIGINAL PAPER

PMC10603554

Enhancing Transsectoral Interdisciplinary Patient-Centered Care for Patients With Rare Cancers: Protocol for a Mixed Methods Process Evaluation

JMIR Research Protocols

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ABSTRACT

Background Rare cancers account for approximately 24% of all new cancers. The category of rare tumor diseases includes almost 200 different entities. In particular, the treatment of patients with extensive care needs requires cooperation between service providers, both between sectors (outpatient and inpatient) and within sectors (eg, between different medical disciplines). The treatment pathway is associated with a high need for coordination and information sharing between providers. When crossing sectoral boundaries in the German health care system, interface problems between the outpatient and inpatient sectors can lead to gaps in care delivery. The multicomponent program Trans-sectoral Personalised Care Concept for Patients with Rare Cancers aims to optimize transsectoral cooperation and coordination of care to enhance patient involvement and the medical care coordination of patients with rare cancers. Objective This process evaluation will contribute to answering questions about intervention fidelity and the implementation of transsectoral communication, identifying and describing the intended and nonintended effects of the intervention, and exploring the barriers to and facilitators of the implementation. Methods We will include patients who participate in the intervention phase; all persons and staff involved in the development and implementation of the intervention (Onco Coach, psychologists, physicians on the contact platform, IT staff, and staff of the Bavarian Association of Statutory Health Insurance Physicians); physicians from the Ludwig-Maximilians-University Hospital Munich and the hospital of the Technical University Munich who are involved in the treatment of patients during the course of the project; and participating office–based hematologists and oncologists. Data collection will be conducted at the beginning, during, and at the end of the intervention using mixed methods. Data will be collected from questionnaires, document analyses, semistructured interviews, and structured observations and will cover different aspects of process evaluation. These include examining the context to explore existing patterns, changes in patterns, attitudes, and interactions; analyzing the implementation of intervention elements; and exploring the complex causal pathways and mediators of the intervention. Qualitative data will be analyzed using thematic analysis. The data will then be combined using between-methods triangulation . Results This project received funding on March 1, 2022. The intervention phase and recruitment for the process evaluation began on March 1, 2023, and the recruitment is expected to end on September 30, 2025. At the time of protocol submission in June 2023, a total of 8 doctors from hematology and oncology practices were enrolled. Data collection began on March 14, 2023. Conclusions The Trans-sectoral Personalised Care Concept for Patients with Rare Cancers project is a complex intervention that is to be implemented in an equally complex health care context. The process evaluation will help understand the influence of contextual factors and assess the mechanisms of change. Trial Registration ISRCTN registry ISRCTN16441179; https://doi.org/10.1186/ISRCTN16441179 International Registered Report Identifier (IRRID) DERR1-10.2196/49731

CITATION EXPORT

Jana Hinneburg, Sandro Zacher, Birte Berger-Höger et al.. Enhancing Transsectoral Interdisciplinary Patient-Centered Care for Patients With Rare Cancers: Protocol for a Mixed Methods Process Evaluation. JMIR Research Protocols. (2023). https://doi.org/10.2196/49731

AUTHORS

7 · 6 CENTRES

Jana Hinneburg, Sandro Zacher, Birte Berger-Höger, Karin Berger-Thürmel, Vanessa Kratzer, Anke Steckelberg, Julia Lühnen

1 Institute for Health and Nursing Science Medical Faculty Martin Luther University Halle-Wittenberg Halle (Saale) Germany
2 Institute for Public Health and Nursing Research Faculty of Human and Health Sciences University of Bremen Bremen Germany
3 Department of Medicine III LMU University Hospital LMU Munich Munich Germany
4 Comprehensive Cancer Center LMU University Hospital LMU Munich Munich Germany
5 Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin Institute of Clinical Nursing Science Berlin Germany
6 see Acknowledgments

EDITOR / REVIEWER

Amaryllis Mavragani, Emily Arden-Close, Sharjeel Chaudhry, Viviana Cortiana