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

Authors


  • Funding information

    Yorkshire Cancer Network; Breast Cancer Care; University of Bradford; Huddersfield University; Calderdale and Huddersfield NHS Trust

  • This is a report of a study that compared the acceptability of an open access, supportive model of follow-up care to women treated for Stage 1 or Stage 2 breast cancer. The innovative model is presented as a feasible alternative to hospital-based follow-up, which provides reassurance, self-management education and prompt access to health care practitioners, if and when required. Quality of Life indicators were used to evaluate and demonstrate feasibility, which was supported.

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.

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