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Evid Based Nurs 4:90 doi:10.1136/ebn.4.3.90
  • Treatment

In older patients with late stage cancer, specialised home care by nurses improved survival after surgery


 
 QUESTION: In older patients, does specialised home care by advanced practice nurses (APNs) increase survival after cancer surgery more than standard care?

Design

Randomised {allocation concealed}*, blinded {outcome assessors}* controlled trial with follow up of 44 months.

Setting

An urban academic health centre in Philadelphia, Pennsylvania, USA.

Patients

375 patients (52% women) who were ≥60 years of age, diagnosed with a solid tumour ≤2 months before surgical removal, and had an anticipated survival of ≥6 months after surgery. Exclusion criteria were non-cancer related surgery, discharge to an institution, or no baseline data before discharge. Follow up was complete.

Intervention

190 patients were allocated to specialised home care. APNs provided comprehensive clinical assessments, monitoring, and teaching to patients and their family caregivers over a 4 week period. Nurses made 3 home visits and 5 telephone calls. Nurses followed guidelines to monitor the …

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