Comparison of breast cancer patient satisfaction with follow-up in primary care versus specialist care: results from a randomized controlled trial
E Grunfeld, R Fitzpatrick, D Mant, P Yudkin, R Adewuyi-Dalton, J Stewart, D Cole, M Vessey, E Grunfeld, R Fitzpatrick, D Mant, P Yudkin, R Adewuyi-Dalton, J Stewart, D Cole, M Vessey
Abstract
Background: Routine follow-up of breast cancer patients in specialist clinics is standard practice in most countries. Follow-up involves regularly scheduled breast cancer check-ups during the disease-free period. The aims of follow-up are to detect breast cancer recurrence and to provide psychosocial support to the patient; however, little is known about patients' views on breast cancer follow-up.
Aim: To assess the effect on patient satisfaction of transferring primary responsibility for follow-up of women with breast cancer in remission from hospital outpatient clinics to general practice.
Method: Randomized controlled trial with 18 months' follow-up in which women received routine follow-up either in hospital outpatient clinics or from their own general practitioner. Two hundred and ninety-six women with breast cancer in remission receiving regular follow-up care at two district general hospitals in England were included in the study. Patient satisfaction was measured by means of a self-administered questionnaire supplied three times during the 18-month study period.
Results: The general practice group selected responses indicating greater satisfaction than did the hospital group on virtually every question. Furthermore, in the general practice group there was a significant increase in satisfaction over baseline; a similar significant increase in satisfaction over baseline was not found in the hospital group.
Conclusion: Patients with breast cancer were more satisfied with follow-up in general practice than in hospital outpatient departments. When discussing follow-up with breast cancer patients, they should be provided with complete and accurate information about the goals, expectations, and limitations of the follow-up programme so that they can make an informed choice.
References
- Cancer. 1984 May 15;53(10 Suppl):2366-75
- Can Fam Physician. 1996 Feb;42:263-8
- Eval Program Plann. 1983;6(3-4):247-63
- Br Med J (Clin Res Ed). 1985 Apr 27;290(6477):1229-30
- BMJ. 1989 Aug 19;299(6697):494-6
- Cancer. 1990 Aug 1;66(3):610-6
- Med Care. 1990 Sep;28(9 Suppl):S3-9
- BMJ. 1990 Sep 22;301(6752):575-80
- Am J Clin Oncol. 1991 Feb;14(1):55-9
- Br J Gen Pract. 1990 Dec;40(341):487-90
- BMJ. 1991 Apr 13;302(6781):887-9
- Soc Sci Med. 1991;32(6):627-32
- BMJ. 1991 May 11;302(6785):1129-32
- Soc Sci Med. 1991;33(6):707-16
- Postgrad Med J. 1992 Nov;68(805):904-7
- JAMA. 1993 Aug 18;270(7):835-40
- Eur J Surg. 1993 Nov-Dec;159(11-12):601-7
- JAMA. 1994 May 25;271(20):1593-7
- CMAJ. 1995 Feb 1;152(3):398-9
- BMJ. 1995 Mar 18;310(6981):685-6
- Med Care. 1995 Apr;33(4):392-406
- Fam Pract. 1995 Mar;12(1):60-5
- Can Fam Physician. 1995 Aug;41:1314-20
- Ann Oncol. 1995;6 Suppl 3:S53-6
- BMJ. 1996 Sep 14;313(7058):665-9
- BMJ. 1996 Oct 5;313(7061):841-4
- J R Coll Gen Pract. 1984 May;34(262):250-4
Source: PubMed