INSPIRE: INtegrated Short-term PallIative REhabilitation to improve quality of life and equitable care access in incurable cancer

与不治之症相关的残疾每年影响100多万欧洲人。我们的目标是测试综合短期姑息康复干预的临床和成本效益，以改善受不治之症影响的人的功能和生活质量。INSPIRE的核心是一项覆盖五个欧洲国家的跨国随机对照试验。我们将招募340名参与者，以评估姑息康复对无法治愈的癌症患者的生活质量、残疾、症状负担和目标实现的临床和成本效益。如果结果是肯定的，这项试验可能会产生一种可扩展的公平干预措施，改善无法治愈的癌症患者的功能和生活质量，并减轻他们家庭的护理负担。利用现有的工作人员和服务，可以调整干预措施并将其整合到不同的卫生系统中，而只需很少或不需要额外费用。为了支持我们将姑息康复作为不可治愈癌症患者常规护理的一部分的雄心，我们还进行了：-卫生服务的比较分析，以了解目前在肿瘤和姑息护理服务中康复的整合；-在患者、卫生服务和卫生系统层面对干预的公平性和包容性、程序和实施进行混合方法评估；-证据综合和关于指标、核心干预、结果和整合方法的德尔菲共识，以制定姑息康复实践和政策的框架。INSPIRE联盟汇集了来自北欧、南欧和北欧国家的姑息治疗、肿瘤学和康复领域的领导者，他们在卫生服务研究、复杂干预试验、混合方法评估、统计学和经济学方面拥有互补的专业知识。我们正在与欧洲公民社会组织合作，以确保最高级别的公民参与和传播。

Disability related to incurable cancer affects over a million Europeans each year. Our objective is to test the clinical and cost effectiveness of an integrated short-term palliative rehabilitation intervention, to improve function and quality of life in people affected by incurable cancer. At the core of INSPIRE is a multinational randomised controlled trial across five European countries. We will recruit 340 participants to assess the clinical and cost-effectiveness of palliative rehabilitation on quality of life, disability, symptom burden and goal attainment in people with incurable cancer. If positive, the trial could result in a scalable and equitable intervention that improves function and quality of life in people with incurable cancer, and reduces the burden of care for their families. The intervention can be adapted and integrated into different health systems using existing staff and services, with little or no additional cost. To support our ambition to make palliative rehabilitation part of routine care for people with incurable cancer we also conduct: - comparative analysis of health services to understand current integration of rehabilitation across oncology and palliative care services; - mixed-method evaluations of equity and inclusivity, processes and implementation for the intervention, at patient, health service and health system levels; - evidence synthesis and a Delphi consensus on indicators, core interventions, outcomes, and integration methods, to develop a framework for palliative rehabilitation practice and policy. The INSPIRE consortium brings together leaders in palliative care, oncology and rehabilitation from Nordic, Southern and Northern European countries, with complementary expertise in health services research, trials of complex interventions, mixed method evaluations, statistics and economics. We are partnering with European civil society organisations to ensure citizen engagement and dissemination at the highest level.