Cancer mostly affects older people. Although older people with cancer are a diverse population, research suggests that cancer and cancer treatments affect them differently than younger people, which may lead to health-related suffering, and poor quality of life and well-being throughout their disease trajectory. This also impacts the family carers.
To sustainably meet the increasing needs for high-quality supportive, palliative, and end-of-life care for older people with cancer and their family within existing EU healthcare systems, navigation interventions hold promise. Navigation interventions aim to support, educate, and empower patients (and in some programs also families), and address individual and community barriers to cancer-related diagnostics, treatment, and care to ensure timely access to needed services and resources. However, in Europe hardly any cancer navigation services have been developed, let alone tested using high-quality research methods.
The EU NAVIGATE project is an interdisciplinary, cross-country and intersectoral project aiming to implement a Navigation Intervention (NavCare-EU) for older people with cancer and their family carers in different health care systems in Europe, and to evaluate its effectiveness and cost effectiveness. NavCare-EU is a person- and family-centered non-pharmacological intervention in which navigators, primarily volunteers and social workers, collaborate with patients and families to improve quality of life and well-being, foster empowerment, and facilitate timely and equitable access to health and social care services and resources as needed, throughout the supportive and palliative care continuum. NavCare-EU is based on the existing and successfully tested Nav-CARE navigation intervention from Canada that had demonstrated feasibility and received positive feedback from clients, indicating benefits such as social support, assistance with navigating healthcare systems, increased knowledge of available services, access to resources, and family respite, contributing to potential improvements in quality of life and well-being.
The effectiveness and cost-effectiveness of NavCare-EU will be evaluated through an international fast-track pragmatic randomized controlled trial (RCT) among cancer patients aged 70 years and older who are in declining health, and their family caregivers, in Belgium, Ireland, Italy, the Netherlands, Poland, and Portugal. We also evaluate the effects of the intervention in specific subgroups based on socio-demographic characteristics that are associated with unequal access to healthcare. An in-depth process evaluation runs alongside the trial to evaluate the implementation process of the intervention, guided by contemporary public health and implementation science frameworks. EU NAVIGATE also conducts a mapping study of existing navigation interventions in Europe and beyond.
