Aims: This study set out to examine contemporary views of cancer supportive care among national and international experts to examine requirement for refreshed definitions of, and a conceptual framework for supportive care, relevant to present-day cancer care.
Methods: A two-round online modified reactive Delphi survey was undertaken. Recruitment was via direct and snowball email invitation. Relevant cancer supportive care terms were identified through a scoping review and presented for assessment by experts (round 1). Terms that achieved ≥ 75% expert agreement as ‘necessary’ were then assessed using Theory of Change (ToC) to develop consensus statements and a conceptual framework. These were presented to participants for agreement in round 2.
Results: In the round 1 Delphi, 55 experts in cancer control and experience of supportive care in cancer took part. Expert consensus assessed current supportive care terminology with 124 terms deemed relevant and ‘necessary’ according to pre-specified criteria. Theory of Change was applied to consensus terms to develop three key definition statements and a refreshed conceptual framework for supportive care. These were presented for expert consensus review in Delphi round 2 (n=37). Thirty six (97%) respondents felt that the definition statements are effective in conveying what cancer supportive care entails; 34 (92%) agreed that the framework contained all components of supportive care and 36 (97%) agreed that they could help inform health system planning. This paper will present the definitional statements and the refreshed conceptual framework for contemporary, integrated supportive care.
Conclusions: Our work contributes new perspectives to the literature on supportive care. It offers health service administrators, policy makers, health services researchers, and multidisciplinary clinicians an opportunity to re-envision supportive care as a conceptual framework to deliver quality cancer care, and importantly orients supportive care as the fundamental lens through which all other aspects of cancer care are delivered.