Table 1
Key stages and procedures used in conducting this scoping review.
| Stage | Description |
|---|---|
| 1. Clarifying purpose and identifying research questions | • Key research questions were shared with the expert panel and questions were refines to balance breadth with feasibility |
| 2. Identifying relevant studies | • Development and refinement of search strategies and selection of databases |
| • Testing and refinements of inclusion and exclusion criterion for screening | |
| 3. Study selection | • Independent application of screening criterion at two levels – title and abstract review and full article review by two reviewers (AIK and EA) |
| • Resolution of disagreements by a third reviewer (VK) to determine final inclusion/exclusion | |
| 4. Data extraction | • Development, testing and application of the data extraction tool |
| 5. Data analysis | • Summarizing descriptive characteristics of included articles |
| • Thematic analysis of extracted data and assessing the implications of findings for future research and policy changes | |
| 6. Consultation with key stakeholders | • Development of a knowledge translation strategy to share the overall conceptual framework and findings with a broad group of stakeholders and experts for further validation |
Figure 1
Overview of article retrieval, screening and data extraction stages.
Table 2
Descriptive features of included articles.
| Descriptive characteristics | Total (n = 67) | Relevant articles |
|---|---|---|
| Type | ||
| Surgical | 28 (41.8%) | [34, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62] |
| Survivorship | 24 (35.8%) | [32, 35, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84] |
| Palliative | 9 (13.4%) | [85, 86, 87, 88, 89, 90, 91, 92, 93] |
| Comprehensive | 5 (7.5%) | [94, 95, 96, 97, 98] |
| Systemic | 1 (1.5%) | [99] |
| Disease sites | ||
| Breast | 18 (26.9%) | [35, 45, 63, 65, 66, 67, 68, 69, 72, 73, 77, 79, 82, 83, 84, 95, 96, 98] |
| All | 11 (16.4%) | [75, 81, 85, 86, 87, 88, 89, 90, 91, 92, 93] |
| Esophagus | 7 (10.4%) | [37, 47, 48, 49, 50, 52, 97] |
| Colorectal | 5 (7.5%) | [41, 43, 46, 64, 80] |
| Multiple1 | 3 (4.4%) | [32, 76, 78] |
| Prostate | 4 (6.0%) | [44, 58, 62, 94] |
| Head and Neck | 4 (6.0%) | [34, 36, 54, 61] |
| Gynecological2 | 5 (7.5%) | [57, 60, 70, 71, 74] |
| Gastric, Bladder, Lung, Pancreatic, Brain, Larynx, and Testicular | 10 (14.9%) | [38, 39, 40, 42, 51, 53, 55, 56, 59, 99] |
| Country | ||
| USA | 27 (40.3%) | [35, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 93] |
| UK | 7 (10.4%) | [46, 47, 48, 49, 72, 92, 98] |
| Canada | 7 (10.4%) | [34, 36, 37, 38, 65, 66, 67] |
| Netherlands | 4 (6.0%) | [70, 71, 88, 89] |
| Germany | 4 (6.0%) | [39, 40, 68, 69] |
| Denmark, Italy, Australia, Singapore, Belgium, China, Japan, Spain, Sweden, Taiwan, Turkey and Multiple3 | 18 (26.9%) | [32, 41, 42, 43, 44, 45, 63, 64, 85, 86, 87, 90, 91, 94, 95, 96, 97, 99] |
| Medium | ||
| Paper | 21 (31.3%) | [38, 39, 47, 49, 55, 57, 59, 60, 61, 62, 65, 71, 74, 75, 78, 80, 82, 83, 85, 98, 99] |
| Combination | 10 (14.9%) | [34, 35, 64, 66, 70, 73, 76, 77, 79, 81] |
| Electronic | 6 (9.0%) | [32, 44, 52, 63, 93, 95] |
| Unclear | 30 (44.8%) | [36, 37, 40, 41, 42, 43, 45, 46, 48, 50, 51, 53, 54, 56, 58, 67, 68, 69, 72, 84, 86, 87, 88, 89, 90, 91, 92, 94, 96, 97] |
| Study design | ||
| Prospective observational (no control) | 25 (37.3%) | [35, 41, 50, 52, 53, 56, 58, 62, 63, 64, 66, 72, 73, 75, 76, 77, 78, 79, 80, 84, 95, 96, 97, 98, 99] |
| Pre and post comparison (with control) | 21 (31.3%) | [34, 36, 37, 38, 39, 42, 43, 44, 45, 47, 48, 49, 51, 55, 57, 60, 61, 86, 88, 91, 93, 94] |
| Prospective observational (with control) | 13 (19.4%) | [46, 50, 53, 54, 59, 69, 81, 82, 85, 89, 90, 92, 95] |
| Randomized control trial | 8 (11.9%) | [40, 65, 67, 68, 70, 71, 74, 87] |
[i] 1Includes two or more disease sites;
2Includes ovarian, cervical, vaginal and/or endometrial cancer;
3The integrated care plan was implemented in multiple countries simultaneously.
Figure 2
Integrated care planning for cancer care framework.
Table 3
Overview of measurement tools used to assess the impact of Integrated Care Plans.
| Indicators | Measurement tool/instrument |
|---|---|
| PATIENT | |
| Quality of life | • Short Form 36 Questionnaire [45] |
| • Short Form 12 [46] | |
| • European Organization for Research and treatment of Cancer Quality-of-life questionnaire [46, 64] | |
| Patient satisfaction | • Medical Outcomes Study – Patient Satisfaction Questionnaire [65] |
| • System Usability Scale (modified) [80] | |
| Anxiety/distress | • Spielberger State-Trait Anxiety Inventory [45] |
| • Brief Symptom Inventory [64] | |
| • Cancer Survivors Unmet Needs Scale [64] | |
| • Impact of Events Scale [65] | |
| • Profile of Mood States [65] | |
| • Distress Thermometer [71] | |
| • Patient-Perceived Coordination Index [94] | |
| • Hospital Anxiety and Depression Scale [72] | |
| Caregiver-reported outcomes | • Toolkit After-Death Family Member Interview [86] |
| • Views of Informal Carers Evaluation of Service Survey [86,88) | |
| • Evaluating Care and Health Outcomes for the Dying [92] | |
| • Family Satisfaction Survey [93] | |
| PROVIDER | |
| Uptake | • Chart reviews/retrospective audit [93] |
| Workflow – Time to complete care plan | • Provider self-report [80] |
| Provider satisfaction | • Telephone interviews [86, 93] |
| • System Usability Scale (modified) [80] | |
| • Consumer Assessment of Healthcare Providers and Systems Adult Specialty Care Clinician Questionnaire (modified) [80] | |
| SYSTEM* | |
| Length of stay | • Number of nights spent in the hospital after surgery |
| Post-operative complications | • Post-operative complication rates |
| Mortality | • In-hospital mortality |
| Readmissions | • Hospital readmissions |
| Costs | • Total costs of hospital stay |
| • Total cost of delivering the plan | |
| • Cost-effectiveness (i.e., quality adjusted life years gained for cost incurred) |
[i] *Since most system-level indicators represent standardized metrics individual references are not provided.