Ottawa Hospital Research Institute and Knowledge Translation Canada logos Ottawa Hospital Research Institute Knowledge Translation Canada

The pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) project

 

1. Purpose

The overall aim was to improve the quality of symptom management by nurses providing remote (telephone) support to adults undergoing cancer treatment.

2. COSTaRS Practice Guides

Guided by CAN-IMPLEMENT© and the Knowledge to Action Framework, we originally developed 13 user-friendly symptom practice guides. Each practice guide was based on a systematic review to identify clinical practice guidelines that were quality appraised using the rigour sub-scale of the AGREE II instrument. They were validated by oncology nurses across Canada.

In March 2016, we updated the 13 symptom practice guides and added 2 new guides (pain, sleep problems) with evidence from a systematic review to identify clinical practice guidelines. We removed AGREE Rigour Scores for source guidelines given inconsistent reporting and medicine evidence ratings were changed to indicate how well the medications work (e.g. effective, likely effective, or expert opinion).

In the 2020 update, we updated the 15 symptom practice guides and added 2 new guides (Mouth Dryness/Xerostomia, Skin Rash). Key assessment items, triage, and medications for patients receiving immune checkpoint inhibitor therapy were added. NCI-CTCAE grading has been linked to applicable assessment questions in the practice guides. The 17 practice guides were reviewed by the current COSTaRS committee members and an Immune Checkpoint Inhibitor Therapy Working Group. A summary of changes for the 2020 update is available here.

These practice guides are available for download in English or French here:

Current original versions English January 2020 Français janvier 2020
Pocket guide versions Pocket Guide January 2020 Guide de Poche Janvier 2020
Canadian Association of Nurses in Oncology website http://www.cano-acio.ca/triage-remote-protocols
Summary of changes between 2016 version and 2020 version Changes 2020 Sommaire des changements 2020
Archive of previous versions

These practice guides are protected by copyright but are freely available for you to use in part or as a whole as needed, provided you:

  • Do not charge for or profit from them;
  • Do not alter them except for customization for a specific setting and reformatting;
  • Cite the resource appropriately, as follows:

    Remote Symptom Practice Guides for Adults on Cancer Treatments © 2020. D Stacey for the Pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) Team. University of Ottawa School of Nursing and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

If you translate any of this material into languages other than English or French, we would appreciate that you notify Dawn Stacey, University of Ottawa.

3. Training materials

We first conducted an environmental scan to explore current telephone-based symptom support training programs for nurses in ambulatory oncology programs across Canada. Then, COSTaRS training materials were developed and evaluated in face to face training sessions and subsequently an English online tutorial. You can download our training materials in English or French here:

Training materials English November 2020 Français novembre 2020
Online training module https://ktcanada.ohri.ca/costars/Tutorial
Canadian Association of Nurses in Oncology website http://www.cano-acio.ca/triage-remote-protocols

These training materials are protected by copyright but are freely available for you to use in part or as a whole as needed, provided you:

  • Do not charge for or profit from them;
  • Do not alter them except for customization for a specific setting and reformatting;
  • Cite the resource appropriately, as follows:

    Using COSTaRS practice guides for cancer symptom support: A Tutorial for Nurses © 2020. D Stacey, L Jolicoeur, B Ballantyne, A Davis, M Carley, for the Pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) Team. University of Ottawa School of Nursing and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

4. Outcome measures

For our implementation studies, we have used several different outcome measurement instruments.

a. Barriers influencing nurses' use of practice guides for remote symptom support; Baseline Barriers Survey Enquête initiale sur les barrières
Barriers assessment based on the Theory of Planned Behaviour The CPD Reaction Questionnaire  
b. Patient satisfaction with telephone services; Patient Satisfaction Survey Enquête de satisfaction du patient
c. Evaluating training in how to use the COSTaRS symptom practice guides; Training Evaluation Survey  
d. Chart audit to monitored use of COSTaRS practice guides and evaluate outcomes. Chart Audit Tool  

If you translate any of this material into languages other than English or French, we would appreciate that you notify Dawn Stacey, University of Ottawa.

5. Videos

6. COSTaRS Publications

COSTaRS Protocol Development and Updates

Barriers assessments

Training

Studies Evaluating the Implementation of COSTaRS

Studies evaluating clinical practice without and with COSTaRS

7. Funding

The COSTaRS project has received funding from:

  • Canadian Partnership Against Cancer (2008-2011)
  • Canadian Institutes of Health Research (CIHR) (2012-2014)
  • Ontario Institute for Cancer Research (OICR) (2016-2017)
  • Canadian Institutes of Health Research (CIHR) Planning and Dissemination Grant (2017)
  • Cancer Care Ontario (CCO) - Clinical Programs and Quality Initiatives (CPQI) (2017-2018)
  • University Research Chair in Knowledge Translation to Patients, University of Ottawa (2012 to present)
  • In-kind methodological and organizational support was provided by the Queen's Group (2008-2011): Margaret B. Harrison (lead), Val Angus, Meg Carley, Kristen Dean, Victoria Donaldson, Janice McVeety, Amanda Ross-White, Joan van den Hoek

8. COSTaRS Team

The COSTaRS Team is a collaboration of researchers, information systems specialists, methodologists, library scientists, advance practice nurses and nurse leaders assembled in 2008. Led by Dawn Stacey, RN, PhD CON(C), the COSTaRS group includes stakeholders from 8 Canadian Provinces and two USA states.

Current Team Members: Dawn Stacey (lead), Meg Carley, Kim Chapman, Andra Davis, Carolyn Fifield, Doris Howell, Lindsay Jibb, Lynne Jolicoeur, Craig Kuziemsky, Luisa Luciani Castiglia, Claire Ludwig, Gail Macartney, Lorraine Martelli, Kristie Morydz, Jennifer Newton, Lorelei Newton, Kathryn Nichol, Komal Patel, Amanda Ross-White, Maureen Smith, Joy Tarasuk.

Immune Checkpoint Inhibitor Therapy Working Group: Jennifer Anderson, Chyanne Dey, Carolyn Fifield, Pam Ginex, Leah Jodoin, Karey McCann, Kristie Morydz, Jennifer Newton, Cindy Railton

Past Team Members: Julie Baisley, Debra Bakker, Barbara Ballantyne, Lorna Butler, Dauna Crooks, Greta Cummings, Esther Green, Barb Hues, Brenda Sabo, Myriam Skrutkowski, Ann Syme, Lucie Tardif, Carolyn Tayler, Tracy Truant, Linda Watson.

For more information regarding the COSTaRS Collaboration, please direct correspondence to:

Dawn Stacey RN, PhD, CON(C)
Lead, COSTaRS Project (Pan-Canadian Oncology Symptom Triage and Remote Support),
University Research Chair in Knowledge Translation to Patients,
Director, Patient Decision Aids Research Group,
Senior Scientist, Ottawa Hospital Research Institute www.ohri.ca/decisionaid
Professor, School of Nursing, University of Ottawa
613-737-8899 ext. 73817; dawn.stacey@uottawa.ca

Last modified: 2022-10-19.



© 2020 Ottawa Hospital Research Institute. University of Ottawa logo