To test the hypothesis that a multimodal intervention giving the general practitioner (GP) an enhanced role in cancer rehabilitation improves patients' health-related quality of life and psychological distress.
Cluster randomised controlled trial. All general practices in Denmark were randomised to an intervention group or to a control group. Patients were subsequently allocated to intervention or control (usual procedures) based on the randomisation status of their GP.
All clinical departments at a public regional hospital treating cancer patients and all general practices in Denmark.
Adult patients treated for incident cancer at Vejle Hospital, Denmark, between 12 May 2008 and 28 February 2009. A total of 955 patients (486 to the intervention group and 469 to the control group) registered with 323 general practices were included.
The intervention included an interview about rehabilitation needs with a rehabilitation coordinator at the regional hospital, information from the hospital to the GP about individual needs for rehabilitation and an encouragement of the GP to contact the patient to offer his support with rehabilitation.
Main outcome measures
The primary outcome was health-related quality of life measured 6 months after inclusion using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Secondary outcomes included quality of life at 14 months and additional subscales of the EORTC QLQ-C30 at 6 and 14 months and psychological distress at 14 months using the Profile of Mood States Scale.
No effect of the intervention was observed on primary and/or secondary outcomes after 6 and 14 months.
A multimodal intervention aiming to give the GP an enhanced role in cancer patients' rehabilitation did not improve quality of life or psychological distress.
ClinicalTrials.gov, registration ID number NCT01021371.
Cancer patients experience a wide range of problems during and after treatment. Unmet rehabilitation needs are frequent.
GPs are expected to play a central role in cancer rehabilitation.
We tested the impact of a multimodal intervention aiming at enhancing GP involvement in cancer rehabilitation on quality of life and psychological distress of the patients.
A multimodal intervention comprising a patient interview about unmet needs and an encouragement to the GP to initiate the rehabilitation process did not improve quality of life or psychological distress of cancer patients.
Interventions aiming to give the GP an enhanced role in cancer rehabilitation seem to have difficulties improving quality of life.
Future studies should evaluate the importance of GP involvement in and the organisation of cancer treatment and rehabilitation.
Strengths and limitations of this study
The study is the largest of its kind evaluating effect of GP involvement in cancer rehabilitation targeting a broad group of patients.
Albeit relevant and well-validated outcome measures were used, some sorts of effects of the intervention may not have been detected.