The Care Plus Study: A multi-site implementation of early palliative care in routine practice to improve health outcomes for people with advanced cancer

A multisite study implementing palliative care for people with cancer to address the gaps between evidence and practice, reduce variation in clinical care, and ensure that best quality care is both timely and delivered routinely for all.

Cancer and its treatment is associated with high levels of suffering for patients and their families (approx. 48,000 Australians die of cancer annually), high hospital use and high cost. Hospitalisations account for 80% of cancer care costs in the last 12 months of life.

Palliative care is proven to reduce suffering, improve survival, reduce health service use including hospitalisation, and reduce cost at the end of life while ensuring care matches patients’ preferences. Currently palliative care is not accessed until very late, if at all, by most patients. Our team has documented the barriers to widespread adoption of timely palliative care, and established and tested an approach to standardizing early palliative care delivery.

This study will take an evidence driven approach to implement standardized, timely palliative care (Enhance) for people with cancer, to improve health outcomes and reduce acute hospitalisation at the end of life. We will conduct a randomised stepped-wedge implementation study, with ‘planning, engagement, intervention delivery and evaluation’ stages at three cancer treatment centres.

The primary objective is to reduce acute hospitalisation days in the last three months of life for people with advanced cancer. Secondary objectives include improved access to timely palliative care, defined as first contact greater than 90 days before death (consistent with the evidence-base for best practice), acceptability according to patients and health professionals, fidelity, quality of end of life care indices, cost, and a scalable package for broader implementation and dissemination.

Early palliative care is a high value proposition, improving health outcomes for patients with advanced cancer AND at lower cost with reduced hospitalisation. Our team is well equipped to systematically implement early palliative care and make widely available the ensuing patient, family and community benefits.

  • Principle investigators
    • Jennifer Philip
    • Vijaya Sundararajan
    • Anna Nowak
    • Meinir Krishnasamy
    • Nicole Rankin
    • Anna Collins
    • Maarten IJzerman
    • Gregory Crawford
    • Brian Le
    • Robyn Hudson
  • Research partners

    Research partner institutions

    • LaTrobe University
    • University of WA
    • University of Sydney
    • University of Adelaide
    • Department of Health Victoria

    Clinical partners

    • St Vincent’s Hospital
    • Peter MacCallum Cancer Centre
    • Melbourne Health
    • Lyell McEwin Hospital
  • Research support

    This project has received support from the Medical Research Future Fund Keeping Australians out of Hospital initiative.

  • Contact

    Professor Jennifer Philip – Principle Investigator

    Roslyn Le Gautier – Project Research Fellow

Jennifer Philip group

Professor Jennifer Philip's Palliative Care Nexus group

Seeking to effect positive and systemic change in palliative care practice, and accelerate the translation of research-generated knowledge to improve patient care.

Visit the group page