The Feasibility of Telephone Follow-up Led by a Radiation Therapist: Experience in a Multidisciplinary Bone Metastases Clinic

Abstract

Telephone follow-up may be a useful tool for outcome assessment in the palliative population, eliminating the need for repeated travel compared with conventional clinical follow-up. The aim of this study was to determine the feasibility of telephone follow-up performed by a radiation therapist (RTT) for patients treated in a multidisciplinary palliative radiotherapy (RT) bone metastases clinic. After training by a nurse practitioner (NP) and radiation oncologist (RO), the RTT performed telephone follow-up for the Rapid Access Palliative Radiotherapy Program Bone Metastases Clinic at the Cross Cancer Institute. Follow-up calls were made to patients at 1 and 4 weeks after completion of palliative RT. Symptoms were evaluated with the Edmonton Symptom Assessment Scale (ESAS). Patient feedback, RTT comfort level with each call and the number of times the RTT needed input from the NP or RO regarding patient management was recorded. Feasibility of telephone follow-up was determined by the percentage of patients who were successfully contacted at the 1- and 4-week periods, the number of patients completing assessments, the number of times that RO or NP input was required, patient feedback, RTT comfort level, and NP and RO feedback. Between February 2 and July 20, 2009, 30 of 53 patients (57%) were contacted at the 1-week follow-up, and 26 (49%) were contacted at the 4-week follow-up. Overall, 72% of patients completed the telephone assessment at 1 or 4 weeks. The RTT required input from the RO or NP for four patients. Patient, NP and RO feedback was positive, and RTT comfort level was high. RTT-led telephone follow-up is a feasible approach for follow-up among patients who have received palliative RT. Future directions include implementation of RTT-led follow-up as part of routine care in the RAPRP and development of RTT capacity in other clinical RT settings.