Systematic review of patients’ and healthcare professionals’ views on patient‐initiated follow‐up in treated cancer patients

Abstract

BackgroundCurrent follow‐up models in cancer are seen to be unsustainable and inflexible, and there is growing interest in alternative models, such as patient‐initiated follow‐up (PIFU). It is therefore important to understand whether PIFU is acceptable to patients and healthcare professionals (HCPs).MethodsStandard systematic review methodology aimed at limiting bias was used for study identification (to January 2022), selection and data extraction. Thematic synthesis was undertaken for qualitative data, and survey findings were tabulated and described.ResultsNine qualitative studies and 22 surveys were included, mainly in breast and endometrial cancer. Women treated for breast or endometrial cancer and HCPs were mostly supportive of PIFU. Facilitators for PIFU included convenience, control over own health and avoidance of anxiety‐inducing clinic appointments. Barriers included loss of reassurance from scheduled visits and lack of confidence in self‐management. HCPs were supportive of PIFU but concerned about resistance to change, unsuitability of PIFU for some patients and costs.ConclusionPIFU is viewed mostly positively by women treated for breast or endometrial cancer, and by HCPs, but further evidence is needed from a wider range of cancers, men, and more representative samples.A protocol was registered with PROSPERO (CRD42020181412).

A systematic review of the effectiveness of patient‐initiated follow‐up after cancer

“…11,43 A recent systematic review of acceptability of PIFU undertaken by the authors of this review found that PIFU is mostly seen as acceptable by women treated for breast or endometrial cancer, but may not be acceptable to a smaller proportion of patients. 44 Facilitators for PIFU included convenience, patients gaining control over their own health and avoidance of anxiety inducing routine appointments; barriers included a loss of reassurance (from routine appointments), difficulties accessing PIFU (especially by non-English language speakers) and avoidance or fear of self-examination. Participants in the included studies were unlikely to be representative of a general cancer population and the review concluded that more representative evidence from a wider range of cancers was needed.…”