386 The need for pilot implementation of a practice guideline on cancer and work among occupational physicians

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IntroductionThe rising incidence and prevalence of cancer is affecting many people in the working age. Continuing employment is a positive outcome since for most cancer survivors, work helps with regaining a sense of normality, provides personal satisfaction, and is associated with health-related quality of life. The Netherlands Society of Occupational Medicine has recently developed an evidence-based guideline on cancer and work for occupational physicians, aiming in particular on vocational rehabilitation of workers with cancer. The guideline focuses on return to work interventions in general, on cancer-related fatigue, and on work-related problems due to mental problems or cognitive disorders. However, resistance from practitioners can be expected as adherence to the given recommendations will require substantial extension of the consultation time and the application of new tools, i.e. specific questionnaires. Therefore, a pilot implementation to evaluate the feasibility in a group of volunteering practitioners; to develop and test training tools; and to formulate the most important preconditions for use of the guideline is needed before national implementation can be carried out.MethodsThe guideline development group has defined performance indicators on key issues of the guideline. In two different regions, 50 volunteering occupational physicians are recruited. After a short training they are asked to apply the guideline in their daily practice and to document their activities in standardised forms. For each case, performance on the chosen indicators is assessed. Low group performance scores on one or more indicators indicate problems with feasibility and will lead to adaptation of the guideline, the further implementation plan, or the formulated preconditions for use of the guideline.ResultResults will be presented.DiscussionPoor implementation is often the Achilles heel of evidence based guidelines in daily practice. Implementation can be improved if with a draft of the guideline pilot implementation in real practice is carried out.

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