Open access follow-up care for early breast cancer: a randomised controlled quality of life analysis

Abstract

This study evaluated the acceptability of a supportive model of follow‐up. One hundred and twelve women recovering from breast cancer were randomised to receive standard breast clinic aftercare (Control n = 56) or on demand by open access aftercare by breast care nurses (Intervention n = 56). Participants attended a support‐based psycho‐educational programme delivered in four half‐day group sessions. Three quality of life questionnaires (EORTC QLQ‐C30, QLQ‐BR23, HADS) were administered at baseline and 6‐monthly intervals for 2 years. Multilevel linear regression modelling methods were used for evaluation. Age was found to be a statistically significant predictor of quality of life in several sub‐scales. Increasing age was negatively associated with sexual functioning, systematic therapy side effects and physical functioning, and positively associated with future perspective. Aftercare assignment was not found to be a statistically significant predictor. Women treated for early breast cancer were not disadvantaged by allocation to the open access supportive care model in terms of quality of life experienced. The model for follow‐up was demonstrated to be a feasible alternative to routinised hospital‐based follow‐up and adds to the evidence for stratified follow‐up for low‐risk cancer patients, incorporating self‐management education. Stratified follow‐up pathways are viewed as a preferable approach.

Patient‐initiated follow up affects fear of recurrence and healthcare use: a randomised trial in early‐stage endometrial cancer

“…Only four randomised trials have compared patient‐initiated follow up with traditional follow up, and these were conducted in breast and colorectal cancer survivors . No evidence of a difference was found with regard to quality of life, anxiety or depression in breast cancer, or for survival in colorectal cancer.…”

“…Patient-initiated follow up has the potential to reduce diagnostic delay by encouraging patients to respond to symptoms immediately, 9 and the patients do not need a referral to specialised care from the GP. 20 These benefits rely on the patient's ability to monitor and react to symptoms without being distressed and require excessive testing by their healthcare provider. Our findings clearly demonstrate that patient-initiated follow up is feasible in endometrial cancer.…”

Systematic review and meta-analysis of patient reported outcomes for nurse-led models of survivorship care for adult cancer patients

“…Twenty one [30,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] publications described 15 interventions of nurse-led models of care for cancer survivorship. Extracted data are presented in Supplement 2; six publications [44,50,51,53,55,56] were secondary analyses of included trials (e.g.…”

“…Twelve studies were RCTs, two were CBA studies and one was a randomised case-control study. The interventions were compared to physician-led follow-up [41,46,48,57,58], conventional nursing care [47,54], usual multi-disciplinary hospital care [43], no intervention [42] or usual care (provider not described) [30,45,59]. Some comparison groups consisted of "attention control", with referral to physicians if needed [40,49], or attention control in addition to multidisciplinary care [31].…”

Optimising SME Potential in Modern Healthcare Systems: Challenges, Opportunities and Policy Recommendations

“…The reliance of SMEs on bank lending and the deleveraging of banks triggered by the economic crisis have contributed to their failure [63]. Access to financing for SMEs was restricted compared to larger companies during that time [64].…”