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A systematic review of clinical trials led or delivered by cancer nurses

A systematic review of clinical trials led or delivered by cancer nurses
A systematic review of clinical trials led or delivered by cancer nurses
Background

Advances in research and technology coupled with an increased cancer incidence and prevalence have resulted in significant expansion of cancer nurse role, in order to meet the growing demands and expectations of people affected by cancer (PABC). Cancer nurses are also tasked with delivering an increasing number of complex interventions as a result of ongoing clinical trials in cancer research. However much of this innovation is undocumented, and we have little insight about the nature of novel interventions currently being designed or delivered by cancer nurses.

Objectives

To identify and synthesise the available evidence from clinical trials on interventions delivered or facilitated by cancer nurses.

Data sources and review methods

A systematic review of randomised controlled trials (RCT), quasi-RCTs and controlled before and after studies (CBA) of cancer nursing interventions aimed at improving the experience and outcomes of PABC. Ten electronic databases (CENTRAL, MEDLINE, AMED, CINAHL, EMBASE, Epistemonikos, CDSR, DARE, HTA, WHO ICTRP) were searched between 01 January 2000 and 31 May 2016. No language restrictions were applied. Bibliographies of selected studies and relevant Cochrane reviews were also hand-searched. Interventions delivered by cancer nurses were classified according to the OMAHA System. Heat maps were used to highlight the volume of evidence available for different cancer groups, intervention types and stage of cancer care continuum.

Results

The search identified 22,450 records; we screened 16,169 abstracts and considered 925 full papers, of which 214 studies (247,550 participants) were included in the evidence synthesis. The majority of studies were conducted in Europe (n = 79) and USA (n = 74). Interventions were delivered across the cancer continuum from prevention and risk reduction to survivorship, with the majority of interventions delivered during the treatment phase (n = 137). Most studies (131/214) had a teaching, guidance or counselling component. Cancer nurse interventions were targeted at primarily breast, prostate or multiple cancers. No studies were conducted in brain, sarcoma or other rare cancer types.

The majority of the studies (n = 153) were nurse-led and delivered by specialist cancer nurses (n = 74) or advanced cancer nurses (n = 29), although the quality of reporting was poor.

Conclusions

To the best of our knowledge, this is the first review to synthesise evidence from intervention studies across the entire cancer spectrum. As such, this work provides new insights into the nature of the contribution that cancer nurses have made to evidence-based innovations, as well as highlighting areas in which cancer nursing trials can be developed in the future.
Cancer care, Clinical trials, Interventions, Nursing
0020-7489
36-43
Charalambous, Andreas
5948f937-487f-484d-8cd1-42e578d1d0db
Wells, Mary
a90862f9-5414-4cec-b956-54525a19f5e5
Campbell, Pauline
7805fa50-2cfb-42b0-a6fe-c09253b4197d
Torrens, Claire
1754429a-20a2-44e1-a59a-1cfd3f10c6f1
Östlund, Ulrika
44f95676-e6f2-48eb-9d80-62e5873cb757
Oldenmenger, Wendy
d2dd45c6-05fe-4a2b-b315-8c038eec2cfe
Patiraki, Elisabeth
53537d68-ee33-44be-8f39-8201e9733aaa
Sharp, Lena
1bd4dcbc-522c-4a48-a1ce-d91901227412
Nohavova, Iveta
4a812bc0-db10-4fed-85f5-4514c6dd388b
Domenech-Climent, Nuria
833a2a55-56b0-4807-bb2a-c29f73bb9ad4
Eicher, Manuela
84731e7d-8b53-41c2-a39b-d757c447d8cf
Farrell, Carole
78c5b2d3-292e-4ce6-80b8-1f9e47eb38e0
Larsson, Maria
c5b403ea-dc5a-4045-b69e-b1f591e5e90a
Olsson, Cecilia
688bbe42-c455-4665-81f8-f67829021382
Simpson, Mhairi
aad021af-e13c-42fa-99f5-74924594bab8
Wiseman, Theresa
e3ff42ae-97ef-4640-af3d-40eeae830df9
Kelly, Daniel
fc06a1fc-e54e-4dfd-8ab6-2ea79dd64bfb
Charalambous, Andreas
5948f937-487f-484d-8cd1-42e578d1d0db
Wells, Mary
a90862f9-5414-4cec-b956-54525a19f5e5
Campbell, Pauline
7805fa50-2cfb-42b0-a6fe-c09253b4197d
Torrens, Claire
1754429a-20a2-44e1-a59a-1cfd3f10c6f1
Östlund, Ulrika
44f95676-e6f2-48eb-9d80-62e5873cb757
Oldenmenger, Wendy
d2dd45c6-05fe-4a2b-b315-8c038eec2cfe
Patiraki, Elisabeth
53537d68-ee33-44be-8f39-8201e9733aaa
Sharp, Lena
1bd4dcbc-522c-4a48-a1ce-d91901227412
Nohavova, Iveta
4a812bc0-db10-4fed-85f5-4514c6dd388b
Domenech-Climent, Nuria
833a2a55-56b0-4807-bb2a-c29f73bb9ad4
Eicher, Manuela
84731e7d-8b53-41c2-a39b-d757c447d8cf
Farrell, Carole
78c5b2d3-292e-4ce6-80b8-1f9e47eb38e0
Larsson, Maria
c5b403ea-dc5a-4045-b69e-b1f591e5e90a
Olsson, Cecilia
688bbe42-c455-4665-81f8-f67829021382
Simpson, Mhairi
aad021af-e13c-42fa-99f5-74924594bab8
Wiseman, Theresa
e3ff42ae-97ef-4640-af3d-40eeae830df9
Kelly, Daniel
fc06a1fc-e54e-4dfd-8ab6-2ea79dd64bfb

Charalambous, Andreas, Wells, Mary, Campbell, Pauline, Torrens, Claire, Östlund, Ulrika, Oldenmenger, Wendy, Patiraki, Elisabeth, Sharp, Lena, Nohavova, Iveta, Domenech-Climent, Nuria, Eicher, Manuela, Farrell, Carole, Larsson, Maria, Olsson, Cecilia, Simpson, Mhairi, Wiseman, Theresa and Kelly, Daniel (2018) A systematic review of clinical trials led or delivered by cancer nurses. International Journal of Nursing Studies, 86, 36-43. (doi:10.1016/j.ijnurstu.2018.05.014).

Record type: Article

Abstract

Background

Advances in research and technology coupled with an increased cancer incidence and prevalence have resulted in significant expansion of cancer nurse role, in order to meet the growing demands and expectations of people affected by cancer (PABC). Cancer nurses are also tasked with delivering an increasing number of complex interventions as a result of ongoing clinical trials in cancer research. However much of this innovation is undocumented, and we have little insight about the nature of novel interventions currently being designed or delivered by cancer nurses.

Objectives

To identify and synthesise the available evidence from clinical trials on interventions delivered or facilitated by cancer nurses.

Data sources and review methods

A systematic review of randomised controlled trials (RCT), quasi-RCTs and controlled before and after studies (CBA) of cancer nursing interventions aimed at improving the experience and outcomes of PABC. Ten electronic databases (CENTRAL, MEDLINE, AMED, CINAHL, EMBASE, Epistemonikos, CDSR, DARE, HTA, WHO ICTRP) were searched between 01 January 2000 and 31 May 2016. No language restrictions were applied. Bibliographies of selected studies and relevant Cochrane reviews were also hand-searched. Interventions delivered by cancer nurses were classified according to the OMAHA System. Heat maps were used to highlight the volume of evidence available for different cancer groups, intervention types and stage of cancer care continuum.

Results

The search identified 22,450 records; we screened 16,169 abstracts and considered 925 full papers, of which 214 studies (247,550 participants) were included in the evidence synthesis. The majority of studies were conducted in Europe (n = 79) and USA (n = 74). Interventions were delivered across the cancer continuum from prevention and risk reduction to survivorship, with the majority of interventions delivered during the treatment phase (n = 137). Most studies (131/214) had a teaching, guidance or counselling component. Cancer nurse interventions were targeted at primarily breast, prostate or multiple cancers. No studies were conducted in brain, sarcoma or other rare cancer types.

The majority of the studies (n = 153) were nurse-led and delivered by specialist cancer nurses (n = 74) or advanced cancer nurses (n = 29), although the quality of reporting was poor.

Conclusions

To the best of our knowledge, this is the first review to synthesise evidence from intervention studies across the entire cancer spectrum. As such, this work provides new insights into the nature of the contribution that cancer nurses have made to evidence-based innovations, as well as highlighting areas in which cancer nursing trials can be developed in the future.

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A systematic review of clinical trials led or delivered by cancer nurses - Accepted Manuscript
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Final_Table 2_RECaN paper 1 Supplementary - Accepted Manuscript
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Final_Table 4_RECaN paper 1 Supplementary - Accepted Manuscript
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More information

Accepted/In Press date: 22 May 2018
e-pub ahead of print date: 26 May 2018
Published date: 1 October 2018
Keywords: Cancer care, Clinical trials, Interventions, Nursing

Identifiers

Local EPrints ID: 423077
URI: http://eprints.soton.ac.uk/id/eprint/423077
ISSN: 0020-7489
PURE UUID: 8fe4ad3d-ca82-465c-a884-fb2016bfcb64
ORCID for Theresa Wiseman: ORCID iD orcid.org/0000-0002-3355-1269

Catalogue record

Date deposited: 13 Aug 2018 16:31
Last modified: 28 Apr 2022 02:11

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Contributors

Author: Andreas Charalambous
Author: Mary Wells
Author: Pauline Campbell
Author: Claire Torrens
Author: Ulrika Östlund
Author: Wendy Oldenmenger
Author: Elisabeth Patiraki
Author: Lena Sharp
Author: Iveta Nohavova
Author: Nuria Domenech-Climent
Author: Manuela Eicher
Author: Carole Farrell
Author: Maria Larsson
Author: Cecilia Olsson
Author: Mhairi Simpson
Author: Theresa Wiseman ORCID iD
Author: Daniel Kelly

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