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A Study of the Effectiveness of Specialist Oncology Nursing Case Management in Improving Continuity of Supportive Cancer Care in the Community (SONICS)

Phase 3
18 Years
Not Enrolling
Continuity of Care, Quality of Life

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Trial Information

A Study of the Effectiveness of Specialist Oncology Nursing Case Management in Improving Continuity of Supportive Cancer Care in the Community (SONICS)

Main Research Question: Does community-based specialist oncology nursing case management
improve continuity of cancer care and lead to fewer unmet cancer patient needs?

Why this research is important: This research proposal addresses the issue of gaps in
continuity of supportive care for cancer patients during the early phases of the disease
trajectory that result in unmet needs and unnecessary morbidity, prior to entry into a
formalized cancer care system (e.g., a regional cancer centre or hospital with a cancer
treatment program). This initial diagnostic period of cancer is associated with significant
stress, anxiety and uncertainty that can impact upon overall quality of life for all types
of cancer. These problems are further exacerbated by waiting times of up to 16 weeks
between diagnosis and attendance in a formalized cancer treatment system. During this time
patients will face a fragmented supportive care service system resulting in a substantial
number of patients reporting unmet needs and distress. These care gaps have significant
implications considering that 38% of women and 41% of men will develop cancer during their
lifetime and that cancer incidence continues to rise with an estimated 139,000 new cases in
Canada (over 54,000 of these in Ontario) in 2003. There has been growing interest in nursing
models to address these gaps in supportive cancer care but at this time there is not
sufficient high quality evidence upon which to base policy decisions to support the
widespread introduction of this type of model. The results of this study will be very
important for policy development for community cancer care in Ontario and in other provinces
in Canada.

What is being studied: We will study the impact of a specialized nursing intervention
(Interlink) on patient outcomes early in the disease trajectory. Impact will be assessed
directly using validated measures in a randomized controlled trial design. These measures
will include: continuity of care, unmet needs, psychological distress, uncertainty in
illness, and quality of life.

Inclusion Criteria:

- Histologically confirmed breast or colorectal cancer.

- In the initial stages of surgical consultation within the randomized surgical

- Not had previous or concomitant malignancies (except for: non-melanoma skin cancer,
or carcinoma in situ of the cervix).

- Have been informed of cancer diagnosis by the surgical office.

- Reside in the Interlink adult program service area.

- Legally able to provide informed consent (18 years of age or older).

- Able to speak and read English.

- Patients from an intervention designated practice, must agree to referral to
Interlink and to receiving an in-home needs assessment.

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label

Outcome Measure:

Difference in unmet supportive care needs between intervention and control group

Outcome Time Frame:

2 to 3 weeks after baseline; 8 to 10 weeks after baseline

Safety Issue:


Principal Investigator

Jonathan Sussman, MD, CCFP, FRCP (c), MSc

Investigator Role:

Principal Investigator

Investigator Affiliation:

Supportive Cancer Care Research Unit


Canada: Health Canada

Study ID:




Start Date:

December 2005

Completion Date:

March 2009

Related Keywords:

  • Continuity of Care
  • Quality of Life
  • unmet supportive care needs