1. ¹Department of Mental Health Sciences, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
2. ²Marie Curie Palliative Care Research Unit, Department of Mental Health Sciences, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2 PF, UK
3. ³King's College London, Florence Nightingale School of Nursing and Midwifery, Waterloo Bridge Wing, Franklin Wilkins Building, Stamford Street, London SE1 8WA, UK
4. ⁴MRC General Practice Research Framework and Department of Primary Care and Population Science, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK

Correspondence: Professor M King, E-mail: m.king@medsch.ucl.ac.uk

Received 4 July 2008; Revised 12 November 2008; Accepted 24 November 2008; Published online 23 December 2008.

Abstract

High experienced continuity of care in patients with cancer is associated with lower needs for care, better quality of life and better psychological outcomes. We developed and evaluated an intervention to improve experienced continuity. The intervention, consisted of (1) a 17-item patient-completed continuity assessment; (2) feedback to clinical nurse specialists and action to address the needs identified. Multidisciplinary team meetings and oncology outpatient clinics were observed, and patients and staff were interviewed. After qualitative work and reliability testing, the intervention was evaluated in a feasibility trial. Sixty-one patients provided data for analysis. No statistically significant differences were found in patients' experienced continuity between the trial arms, but important trends were seen in measures of needs for care in favour of those receiving the intervention. Feeding back findings from the continuity assessment to clinicians reduced patients' needs for care. Our results indicate that an intervention to target patients' experiences of continuity can reduce their subsequent needs for care. However, overcoming barriers to organisational change and addressing some patients' hesitation to report their continuity difficulties must be considered when implementing such an intervention. A phase III trial targeting patients with inadequate experienced continuity of care is recommended.