Nurse-led follow-up care for cancer patients: what is known and what is needed

Abstract

Traditionally, cancer patient follow-up has focused on disease surveillance and detecting recurrence. However, an increasing number of patients who have survived cancer acknowledge the importance of cancer rehabilitation issues and the need for more patient-oriented models of care by reporting their unmet physical, emotional, and social needs. Nurse-led follow-up care for cancer patients fulfills this need and has been developing gradually for various cancer diagnoses and prognoses. A growing body of evidence suggests that these services provide high-quality care that is both safe and efficient. Furthermore, patients benefit from the continuity of care and easy access to support for their multitude of needs, provided by such organized care. In this paper, we review the literature published in the past 5 years regarding nurse-led follow-up care for cancer patients in order to provide input and opinion for future research, clinical practice development, and nursing leadership. We pay special attention to head and neck cancer patients, a group that has been largely understudied and hence underreported in the literature. These patients have specific needs with respect to information and education regarding their cancer and potential treatment side-effects as well as a particular need for long-term psychosocial support and practical advice.

Models of survivorship care provision in adult patients with haematological cancer: an integrative literature review

“…Current conventional models of survivorship care, including routine follow-up, predominately focus on surveillance for recurrence and monitoring of physical side effects, rather than provision of supportive care, health promotion, late effects monitoring and surveillance for new cancers [6,7]. With an increasing awareness that communication between health care professionals and patients is suboptimal and that information provided to patients and primary care providers at treatment completion is often inadequate [8,9], there is a growing movement to redesign how survivorship follow-up care is delivered.…”

“…Two systematic reviews [19,20] and a literature review [6] on survivorship models of care have been recently published. Sussman et al [20] reviewed 12 randomised controlled trials (RCTs) and four systematic reviews.…”

“…Sussman et al [20] reviewed 12 randomised controlled trials (RCTs) and four systematic reviews. De Leeuw, Larsson [6] reviewed 21 nurse-led follow-up studies and Howell et al [19] evaluated 10 practice guidelines and nine RCTs. All primary outcomes in the reviewed studies were related to recurrence detection and in some cases healthrelated quality of life and/or patient satisfaction [6,19,20].…”

“…De Leeuw, Larsson [6] reviewed 21 nurse-led follow-up studies and Howell et al [19] evaluated 10 practice guidelines and nine RCTs. All primary outcomes in the reviewed studies were related to recurrence detection and in some cases healthrelated quality of life and/or patient satisfaction [6,19,20]. Importantly, all studies included cancers with similar trajectories of care (breast, prostate, colon) making generalisations to other complex cancers such as haematological cancers difficult.…”

“…They can involve longer consultations and more frequent patient contact [27,6]. PCP-led models involved a complete transition of all care from the hospital specialist to PCP [28,5,9].…”