Efficacy and cost-effectiveness of an online mindfulness program (MindOnLine) to reduce fear of recurrence among people with cancer: study protocol for a randomised controlled trial.

INTRODUCTION: Fear of cancer recurrence (FCR) is a common condition among cancer survivors that can lead to significant levels of distress, anxiety and depression. Online mindfulness programmes may provide the mechanism to support cancer survivors manage FCR and distress, and improve people's well-being over the short, medium and long term. The primary aim of this study is to determine the potential efficacy of MindOnLine, a 9 session mindfulness-based programme for survivors of breast, prostate and colorectal cancer. A formal economic programme will also be conducted. METHODS AND ANALYSIS: A single-blind randomised controlled trial to determine the efficacy and cost-efficacy of a MindOnLine programme for cancer survivors. A total of 400 people living with cancer will be recruited via online advertisements on social media platforms, peak consumer advocacy groups or through outpatient services at healthcare providers across Victoria, Australia. People will be randomly allocated to either the MindOnLine programme (n=200) or waitlist control (n=200). Participant assessments will occur at baseline, at 9 weeks and 9-month follow-up. The primary outcome is change in Fear of Recurrence Index Score total score between baseline and 9 weeks; secondary outcomes are changes in depression and anxiety, quality of life and mindfulness. The economic analysis comprises a cost-consequences analysis where all outcomes will be compared with costs. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Peter MacCallum Cancer Centre (20-53) and Deakin University (2020-284). All participants will be required to provide written informed consent. Findings will be disseminated in peer reviewed journals and among key stakeholder organisations including hospitals, cancer and community organisations and Government. If successful the project will be rolled out nationally with a formal implementation plan. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (12620000645954); Pre-results. Registered 6 June 2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379520&isReview=true.

A clinical placement program for primary care professionals at a comprehensive cancer centre.

BACKGROUND: There is a growing number of cancer survivors and increasing interest in models of patient-centred shared care between oncology and primary care. OBJECTIVE: The objective of this article was to investigate whether a placement program for general practitioners (GPs) and general practice nurses (GPNs) was feasible, of clinical and professional value, and facilitated knowledge and skills transfer. METHODS: The program recruited GPs and GPNs to complete a 10-hour placement at a cancer centre. Participants completed pre-placement and post-placement semi-structured interviews. RESULTS: The participants for the study included 16 GPs, 12 GPNs and nine oncologists. All generalists reported that the program's learning outcomes, personal learning needs and relevance to practice were 'entirely' or 'partially' met All would recommend the program and could identify knowledge and skills transfer; however, learning was largely by observation rather than participation. Learning opportunities were skewed towards generalists. Participants showed enthusiasm to address the challenges of providing shared care. DISCUSSION: The clinical placement program was feasible and highly regarded.