A new cross-disciplinary model for early integration of palliative care for patients with incurable cancer - an intervention development study.

BACKGROUND

Patients with incurable cancer face complex physical, psychological, social, and existential challenges. Early integration of palliative care (PC) has proven essential to improve quality of life and well-being, yet implementation remains inconsistent and often delayed. To address this gap, we developed the Cross-PALL model, a cross-disciplinary approach to integrate PC across oncology and primary care.

METHODS

Following the Medical Research Council’s framework for complex interventions, we used a participatory design approach to develop the model in collaboration with key stakeholders, including patients, their relatives, healthcare professionals from oncology, primary care, municipal services and representatives from voluntary organizations. Development involved iterative phases of evidence synthesis, needs assessment, field studies, collaborative workshops, and prototyping. For each of these phases, various methods and activities are applied to enhance genuine participation from all collaborators. Implementation determinants were continuously identified using the Consolidated Framework for Implementation Research, and a logic model was constructed to link determinants, implementation strategies, mechanisms, and outcomes.

RESULTS

The Cross-PALL model is structured as a standardized care pathway designed to ensure systematic, person-centered, and coordinated PC. Key components include early initiation of PC at diagnosis, routine patient-reported outcome assessments, decision aids, navigation support, structured inter-sectoral communication, and integration of advance care planning.

CONCLUSION

The Cross-PALL model offers a feasible, scalable, evidence-informed approach to strengthen early PC integration in oncology. By combining implementation science with participatory design, the model aims to enhance relevance, sustainability, and continuity of care, ultimately supporting patients’ quality of life and well-being.