The intensity and complexity of care offered were quantified through the use of a validated instrument, and clinics were categorized as high, medium or low intensity clinics.
Although the high intensity clinics had higher mean scores in 9 of the 10 HF-DMSI categories, this was most pronounced in the education and counselling, medication management, delivery personnel and complexity categories.
5 40 Previous reports describe mixed success using low intensity mail based programmes or more intensive clinic based programmes.
Phase 2 will build on these data to design and test the feasibility of a practical, low-intensity, clinic-integrated intervention using a self-management paradigm.
We have shown that therapy-based risk stratification of long-term survivors of childhood and teenage cancer can predict which patients are at risk of developing moderate-to-severe side effects and require high-intensity clinic-based LTFU.
Based on two studies of low-intensity clinic-based weight loss interventions, we estimate that approximately 20% of patients in the SRA+G arm will lose 5% of their body weight over the course of a year, compared to approximately 10% of patients in the SRA arm [ 36, 37].
Based on our concept mapping exercise, the expert panel categorized the 30 identified clinics into three strata of intensity; 8 clinics were assigned to the low intensity category, with 12 in the medium intensity category and 10 in the high intensity group.
Gold standard for assessing pain intensity in clinics and research are VAS and NRS, but they are also used in psychology, psychiatry, or for quality-of-life assessments.
For this reason, power for detecting differences according to level of ID intensity using oncology outpatient clinic care teams as the analytic unit cannot be the primary concern; our approach will be exploratory.
Finally, although we have categorized clinics into intensity strata based on expert opinion, the relevance of such categories is dependent on their association with improved patient outcomes.
These low-intensity features of clinic-integrated prevention programs are more translatable into routine care, since specialized psychological expertise is not required to identify, target, and treat individual "cases".
