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

与无法治愈的癌症相关的残疾每年影响着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，以改善无法治愈的癌症患者的功能和生活质量。INSPIRE的核心是一项跨越五个欧洲国家的多国随机对照试验。我们将招募340名参与者来评估姑息康复在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方面的临床和成本效益。如果结果是积极的，该试验可能会导致可扩展和公平的干预措施，改善无法治愈的癌症患者的功能和生活质量，并减轻其家庭的护理负担。可以利用现有的工作人员和服务对干预措施进行调整，并将其纳入不同的卫生系统，很少或不需要额外费用。为了支持我们将姑息康复纳入无法治愈癌症患者常规护理的目标，我们还进行了：-对卫生服务进行比较分析，以了解目前肿瘤和姑息治疗服务之间的康复整合；-在患者、卫生服务和卫生系统各级对干预的公平性和包容性、过程和实施情况进行混合方法评估；-对指标、核心干预措施、结果和整合方法进行证据综合和德尔菲共识，以制定姑息康复实践和政策框架。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人，他们在卫生服务研究、复杂干预措施试验、混合方法评估、统计学和经济学方面具有互补的专门知识。我们正在与欧洲民间社会组织合作，以确保公民参与和最高水平的传播。

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.