Ietje Perfors

92 Chapter 4 on the Dutch Distress Thermometer, which contains several items of the four domains on which patients are asked to rank their level of distress. 19 Throughout the cancer continuum the HON will report the status of the patient and the required actions to the GP, and if necessary the GP will be actively involved in the care provision. Secondary care will be actively approached by the HON, if supportive care, e.g., consultation of a psychologist, physiotherapist or dietician, is started based on HON’s consultations or when treatment-specific questions arise. Intervention training All the participating HONs are registered nurses with a specialised training in oncology and have more than 2 years of clinical experience. In addition, the GRIP study team provides a 4-hour training regarding supportive care, recognizing alarm-symptoms and the details of the GRIP intervention in order to be able to comply optimally with the intervention procedures. This includes close collaboration with the GP, the minimal content and frequency of consultations and the registrations required for the GRIP study. Expectations of all actors are displayed in table 1. Participating GPs receive basic information on the GRIP study by their GP cooperatives organisations at the start of the study. The GPs of patients who are randomised to the intervention group are notified by phone after the patient provides informed consent for participation. During this telephone contact, the researcher provides the necessary instruction to perform a Time Out consultation. In addition, information is given by e-mail and through a website which describes the steps GPs are expected to take. This website also provides the information required for optimal guidance from primary care and collaboration with HON and secondary care providers.