The success of data collection in the palliative setting?telephone or clinic follow-up?

Abstract

Assessment of outcomes is essential in order to improve available palliative treatments. Collecting follow-up information can be a challenging task in the palliative setting. We compared the effectiveness of data collection by telephone contact and clinic visit in 112 patients with brain metastases treated with whole-brain radiotherapy. The first 56 patients (group A) were followed by telephone only. The second 56 patients (group B) were asked to attend an outpatient clinic appointment 4 weeks after radiotherapy. Successful contact was defined as obtaining data at week 4. Patients in the two groups did not differ significantly with regard to age, sex, performance status, primary site, number of brain metastases, or the treatment given. The proportions of patients with successful follow-up contact at week 4 were 45% and 61% in groups A and B, respectively ( P = 0.09). The quality of the collected data did not differ significantly between the two groups. The side effects and responses to therapy were similar. However, there were significantly more patients with a reduced dose of dexamethasone among the successful contacts in group B, which probably reflected the better condition of the patients coming back to clinic at week 4. In conclusion, there was a trend towards more successful data collection in our clinic follow-up. Some of the observed outcome data suggest that the two methods of follow-up might be reaching different populations of patients; considering this and the high attrition rate, a combined follow-up strategy of clinic and telephone contacts might be the best strategy.

The rapid access palliative radiotherapy program: blueprint for initiation of a one-stop multidisciplinary bone metastases clinic

“…This approach decreases the time invested in medical appointments and allows patients to remain in their home communities. The proportion of patients reachable by phone at week 4 (72%) in this study compares favorably with literature reports of 45% [13] and 50% [6]. Follow-up data was unavailable for 94/218 (43%) of patients seen over a 3-year period at another Canadian rapid access clinic, in part due to missed follow-up visits and long travel distances [21].…”

“…It is unnecessary, and some would say, futile, to require asymptomatic but incurable patients to attend clinic after successful treatment [13]. This is especially true for our patient population who traveled an average of 212 km (round trip) per clinic visit.…”

“…Follow-up by telephone has been reported as feasible by multiple authors [6,13] and was favored by our team for multiple reasons. It is unnecessary, and some would say, futile, to require asymptomatic but incurable patients to attend clinic after successful treatment [13].…”

Review of telephone follow-up experience at the Rapid Response Radiotherapy Program

“…Haddad et al compared the effectiveness of data collection by telephone contact and clinic visit in 112 patients with brain metastases treated with whole-brain radiotherapy [3]. The proportion of patients with a successful followup contact at week 4 was 45% and 61%, respectively.…”

Beyond palliative radiotherapy: a pilot multidisciplinary brain metastases clinic

“…However, most studies of patients with brain metastases have shown poorer response rates in follow-up, regardless of whether the assessment is performed by telephone, clinic visit, or by mail. In a study comparing telephone and clinic follow-up, the response rates at week 4 were only 45% for telephone assessment, compared to 61% for clinic assessment [42]. In two studies using either clinic or mail assessments in follow-up, response rates were 45% [43] and 47% [44] at week 4.…”