Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months

Batehup, L.; Porter, Kirsty; Gage, H.; Williams, P.; Simmonds, P.; Lowson, E.; Dodson, L.; Davies, N. J.; Wagland, Richard; Winter, J.D.; Richardson, A.; Turner, A.; Corner, Jessica

Abstract

Purpose: To compare patient-triggered follow-up (PTFU) for curatively treated colorectal cancer against traditional outpatient follow-up (OPFU).
Methods: Questionnaires were mailed at four time points over one-year post-treatment to two prospectively-recruited cohorts: A, patients entering follow-up and receiving OPFU pre-implementation of PTFU; B, patients entering follow-up (FU) and receiving either OPFU (B1) or PTFU (B2) post-implementation of PTFU. Bi-variate tests were used to compare patient characteristics and outcomes eight months after entering follow-up (generic and cancer-specific quality of life (QoL), satisfaction). Regression analysis explored associations between follow-up model and outcomes. Resource implications and costs of models were compared.
Results: Patients in Cohort B1 were significantly more likely to have received chemotherapy (p<0.001), radiotherapy (p<0.05), and reported poorer QoL (p=0.001). Having a longstanding co-morbid condition was the most important determinant of QoL (p<0.001); model of care was not significant. Patients were satisfied with their follow-up care regardless of model. Health service costs were higher in PTFU over the first year.
Conclusions: PTFU is acceptable to patients with colorectal cancer and can be considered to be a realistic alternative to OPFU for clinically suitable patients. The initial costs are higher due to provision of a self-management (SM) programme and remote surveillance. Further research is needed to establish long-term outcomes and costs.

Citation

Batehup, L., Porter, K., Gage, H., Williams, P., Simmonds, P., Lowson, E., Dodson, L., Davies, N. J., Wagland, R., Winter, J., Richardson, A., Turner, A., & Corner, J. (2017). Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months. Supportive Care in Cancer, 25(7), 2063-2073. https://doi.org/10.1007/s00520-017-3595-x

• Journal Article Type: Article
• Acceptance Date: Jan 21, 2017
• Online Publication Date: Feb 14, 2017
• Publication Date: 2017-07
• Deposit Date: Feb 8, 2017
• Publicly Available Date: Feb 14, 2017
• Journal: Supportive Care in Cancer
• Print ISSN: 0941-4355
• Electronic ISSN: 1433-7339
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Issue: 7
• Pages: 2063-2073
• DOI: https://doi.org/10.1007/s00520-017-3595-x
• Keywords: colorectal cancer; aftercare; follow-up; patient triggered-follow-up; remote surveillance
• Public URL: https://nottingham-repository.worktribe.com/output/845803
• Publisher URL: http://link.springer.com/article/10.1007/s00520-017-3595-x
• Contract Date: Feb 8, 2017