Models Of Follow-up Care Research Articles

PTU-095 A qualitative exploration of inflammatory bowel disease patient perceptions of primary care in the UK

IntroductionMany patients with IBD in the UK are managed primarily in secondary care with minimal General Practitioner (GP) involvement or within a restricted shared care protocol. As UK NHS hospitals...

PMO-024 A qualitative exploration of inflammatory bowel disease patient attitudes towards self management and new modes of care delivery

IntroductionEquity and excellence: Liberating the NHS (2010) states that new modes of care delivery must be explored for patients with long term conditions (LTCs). Increasing the proportion of people with...

100 The meaning and significance of routine follow-up in lung cancer: A qualitative study of patient's experiences and the development and evaluation of a new model of follow-up care

100 The meaning and significance of routine follow-up in lung cancer: A qualitative study of patient's experiences and the development and evaluation of a new model of follow-up care

Patient expectations and preferences for follow-up after treatment for lung cancer: A pilot study

Introduction There is no robust evidence to indicate the most appropriate models of follow-up care for patients who have completed treatment for lung cancer. This pilot study aimed to assess expectations and preferences for follow-up care in a sample of patients who had completed treatment for lung cancer. Method Thirty-one patients who had completed treatment for primary lung cancer were recruited. A 13 item self-report survey was developed to elicit patient's preferences and expectations for follow-up. Participants completed the developed survey and clinical and demographic variables were collected. Results Factors scored as extremely important by over 80% of respondents focused on care coordination: Being able to see the same doctor or health care professional at each visit (24/83%); Knowing which doctor or nurse to contact if queries arise between follow-up appointments (23/82%); and Knowing the patient can book an appointment or contact a health care professional involved in their care regarding health concerns between visits (25/89%). Patients were supportive of nurse-led follow-up when offered in the context of a model of shared care (21/78%). Conclusion This study offers new insight into the expectations and preferences for follow-up of patients with lung cancer, with participants indicated preference for intensive follow-up after the completion of treatment.

Adult Cancer Survivorship: Evolution, Research, and Planning Care

Increases in the number of adult cancer survivors and other issues have forced the oncology community to examine, evaluate, and alter the cancer care paradigm. Pediatric oncologists are grappling with the task of transitioning a growing population of adult survivors of childhood cancer to adult medicine, while oncologists caring for adult cancer survivors are seeking models of follow-up care that are acceptable to patients and providers. Workforce and access-to-care issues suggest that primary care providers will see more cancer survivors in their practices across time, although it is unclear how prepared they are for this task. Translational research is needed to develop evidence-based clinical care and survivorship care plans. A broad picture of the evolving field of adult cancer survivorship is presented. The recent focus on young adult survivors of childhood cancer, an overview of translational research needed to inform the physical and psychosocial care of cancer survivors, and the roles of primary and specialty care providers managing this population is examined. Finally, an overview of evolving treatment summary and care plan initiatives is presented.

Identifying Key Questions to Advance Research and Practice in Cancer Survivorship Follow-Up Care: A Report From the ASPO Survivorship Interest Group

Cancer survivorship encompasses the physical, psychosocial, and economic consequences of cancer, including issues related to health care and follow-up treatment, late effects of treatment, surveillance for recurrence of the primary, screening for second primary cancers, and quality of life. Almost

Follow-up care for men with prostate cancer and the role of primary care: a systematic review of international guidelines.

The optimal role for primary care in providing follow-up for men with prostate cancer is uncertain. A systematic review of international guidelines was undertaken to help identify key elements of existing models of follow-up care to establish a theoretical basis for evaluating future complex interventions. Many guidelines provide insufficient information to judge the reliability of the recommendations. Although the PSA test remains the cornerstone of follow-up, the diversity of recommendations on the provision of follow-up care reflects the current lack of research evidence on which to base firm conclusions. The review highlights the importance of transparent guideline development procedures and the need for robust primary research to inform future evidence-based models of follow-up care for men with prostate cancer.

Optimizing follow-up after breast cancer treatment

This review focuses on studies that help elucidate the optimum approach to posttreatment follow-up of breast cancer patients. The re-conceptualization of follow-up under the rubric of survivorship care and the benefit of survivorship care plans, studies on the elements of follow-up care including surveillance mammograms, alternative models of follow-up care including primary care based follow-up, and patterns of care studies that involve population-based samples are discussed. Posttreatment follow-up of breast cancer patients continues to be controversial despite almost two decades of research. The research does show that surveillance mammograms are beneficial and guidelines recommend routine surveillance mammograms annually. Other routine surveillance tests are not beneficial and are not recommended. The precise frequency and duration of clinical visits is not known and recommendations vary; but most do support continued clinical assessment. Alternative models, such as nurse-led follow-up or less frequent follow-up, show good patient satisfaction and quality-of-life outcomes. Primary care based followup results in similar clinical and quality-of-life outcomes as specialist-based follow-up. Instead of trying to find a one-size-fits-all approach, the focus should be on an individualized tailored approach in which the patient makes an informed decision on the basis of evidence of actual benefits and risks.

The case for nurse led follow-up

Nurse led care is expanding. In particular nurse led follow-up has a substantial body of evidence to support its development (Campbell et al 1999; Corner 1997). Nurses are seizing opportunities to revolutionise the traditional medical model of follow-up care within cancer services, with a supportive, collaborative approach. The drivers and barriers that have influenced this practice, along with the future of nurse led follow-up care in advancing cancer nursing practice, are discussed.

Follow-up after Primary Treatment for Breast Cancer

Follow-up after primary treatment for breast cancer is a routine practice aiming at early detection and management of local recurrences and/or distant metastases of the disease or of new primaries. Breast self-examination and periodic physical examination, mammography, and pelvic examination are the most important methods in following-up these patients. The, at one time, more popular intensive routine diagnostic evaluation (including head, chest, abdominal, and pelvic computerized tomography and/or magnetic resonance imaging, liver ultrasonography, bone scans, tumor markers, etc.) is not currently considered appropriate and cost-effective. However, flexibility, based on clinical judgement, is required on the part of medical staff involved in the follow-up in order appropriately to adapt the general guidelines and meet the specific needs of the individual patients. Non-specialist or non-physician models of follow-up care have been proposed as interesting and cost-effective alternatives in the follow-up of breast cancer patients.

Development of nurse-led follow-up in the management of patients with lung cancer

This paper describes the first two phases of an NHS R&D-funded study to develop and evaluate an alternative model of nurse-led follow-up care in the management of patients with lung cancer. Phase I of the study identified the needs of lung cancer patients during their follow-up period of care. This was achieved through observation of outpatient consultations and an audit of patients' medical records. Phase two of the study developed and piloted a nurse specialist-led model of follow-up care. This model moved away from the existing medical one focusing on disease surveillance towards a more patient-centred model responsive to the specific needs of lung cancer patients that were identified during Phase 1. The paper concludes that nurse-led follow-up care of lung cancer patients was demonstrated to be safe, acceptable and appropriately managed. Patients in the study reported positive benefits from a model of care responsive to the experience of, and needs arising from, living with lung cancer.