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Assessing patient outcomes and cost effectiveness of nurse-led follow-up for women with breast cancer: have relevant and sensitive evaluation measures been used?
University of Skövde, School of Health and Education. University of Skövde, Health and Education. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden. (Äldre och långvariga hälsoproblem, Health and Ageing)ORCID iD: 0000-0003-0976-531X
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden / Karolinska University Hospital, Breast and Sarcoma Unit, Radiumhemmet, Sweden.
2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

Aim

To explore how interventions using nurse-led follow-up in breast cancer care have been evaluated with a focus on patient outcomes and cost effectiveness.

Background

As part of the advancement of breast care, nurse-led follow-up is increasingly used as an alternative to routine hospital follow-up in outpatient clinics. There is evidence suggesting that patients appear to be satisfied with the nurse-led follow-up, but there is a lack of evidence of whether this perception equates to patients’ satisfaction with the model of physician-led follow-up.

Design

Systematic review.

Method

Three databases were searched, and 29 RCT were initially screened. Finally, 13 articles were critically appraised. Searches included articles between 2005 and 2013. The quality of appraisal assessment was inspired by the GRADE system.

Results

The results show that there are many different instruments used when evaluating nurse-led follow up which makes it difficult to compare the studies. Several of the studies used QoL as an outcome measure; this is a broad concept that includes several aspects ranging from social role and psychosocial issues to symptoms and therefore difficult to use as an outcome measure. Only two of the studies made any cost-effective analyses and the results are hard to interpret.

Conclusions

Nurse-led follow-up can potentially result in better continuity of care and the availability of more time to provide psychosocial support and address patients’ information needs. However, more well-conducted research is needed before equivalence to physician-led follow-up can be assessed in terms of survival, recurrence, patient well-being and cost-effectiveness.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017.
Keyword [en]
quality of life, symptoms, psychosocial support, cost effectiveness, nurse-led follow-up, breast cancer
National Category
Nursing
Research subject
Medical sciences
Identifiers
URN: urn:nbn:se:his:diva-13188DOI: 10.1111/jocn.13496PubMedID: 27487478OAI: oai:DiVA.org:his-13188DiVA: diva2:1052164
Available from: 2016-12-05 Created: 2016-12-05 Last updated: 2017-02-16Bibliographically approved

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CiteExportLink to record
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