Shared care follow-up of patients with B-cell neoplasms based on nurse-led telephone consultations and PRO-data: a feasibility study from the North Denmark Region

Abstract

Background

Patients with B-cell neoplasms in remission are monitored with regular physician visits at the hospital. The current standard follow-up procedure is not evidence-based or individualized to patient needs. To improve and individualize the follow-up, we investigated the feasibility of a shared care follow-up initiative, with alternating physician visits and nurse-led telephone consultations and assessments based on patient-reported outcome (PRO) data.

Methods

Patients ≥18 years diagnosed with B-cell neoplasms were eligible for the study when they were in remission and stable without treatment for at least 6 months. Patients were assigned to alternating visits with physicians and nurse-led telephone consultations. The nurse-led telephone consultations were based on PROs, which were collected with the European Organization for Research and Treatment of Cancer questionnaire (EORTC-QLQ-C30), the Myeloproliferative Neoplasm – Symptom Assessment Form, and the Hospital Anxiety and Depression Scale. Patients completed questionnaires before every nurse-led consultation. We also applied the Patient Feedback Form to survey patient acceptance of the requirement of questionnaire completion. We applied descriptive statistics, in terms of counts (n) and proportions (%), to describe the study population and all endpoints.

Results

Between February 2017 and December 2018, 80 patients were enrolled. Adherence, measured as the recruitment rate, was 96% (80/83), and the drop-out rate was 6% (5/80). During the study period, 3/80 (4%) patients relapsed, and 5/80 (6%) patients returned to the standard follow-up, because they required closer medical observation. Relapses were diagnosed based on unscheduled visits requested by patients ( n = 2) and patient-reported symptoms reviewed by the nurse ( n = 1). The response rate to questionnaires was 98% (335/341). A total of 58/79 (74%) patients completed the Patient Feedback Form; 51/57 (89%) patients reported improved communication with health care professionals; and 50/57 (88%) patients reported improved recollection of symptoms as a result of completing questionnaires.

Conclusion

Based on patient adherence, a low relapse rate, and positive patient attitudes towards completing questionnaires, we concluded that a shared care follow-up, supported by PROs, was a feasible alternative to the standard follow-up for patients with B-cell disease in remission.

Contributors

Mia Sommer:

ORCID: http://orcid.org/0000-0002-9761-6201

[e-mail]

Journal

Journal ID (nlm-ta): BMC Health Serv Res

Journal ID (iso-abbrev): BMC Health Serv Res

Title: BMC Health Services Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6963

Publication date (Electronic): 17 November 2020

Publication date PMC-release: 17 November 2020

Publication date Collection: 2020

Volume: 20

Affiliations

[1 ]GRID grid.27530.33, ISNI 0000 0004 0646 7349, Department of Hematology, , Aalborg University Hospital, ; Sdr. Skovvej 15, DK-9000 Aalborg, Denmark

[2 ]GRID grid.5117.2, ISNI 0000 0001 0742 471X, Department of Clinical Medicine, , Aalborg University, ; Aalborg, Denmark

[3 ]GRID grid.27530.33, ISNI 0000 0004 0646 7349, Clinical Nursing Research Unit, , Aalborg University Hospital, ; Aalborg, Denmark

[4 ]GRID grid.27530.33, ISNI 0000 0004 0646 7349, Clinical Cancer Research Center, , Aalborg University Hospital, ; Aalborg, Denmark

Article

Publisher ID: 5899

DOI: 10.1186/s12913-020-05899-8

PMC ID: 7670769

PubMed ID: 33198756

Copyright statement: © The Author(s) 2020

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Funding

Funded by: Region Nordjylland (DK)

Categories

Subject: Research Article

Custom metadata

issue-copyright-statement © The Author(s) 2020