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Abstract

Background: Specialist-led cancer follow-up is becoming increasingly expensive and is failing to meet many survivors’ needs. Alternative models informed by survivors’ preferences are urgently needed. It is unknown if follow-up preferences differ by cancer type. We conducted the first study to assess British cancer survivors’ follow-up preferences, and the first anywhere to compare preferences of survivors from different cancers.
Methods: A discrete choice experiment questionnaire was mailed to 1,201 adults in Northeast Scotland surviving melanoma, breast, prostate or colorectal cancer. Preferences and trade-offs for attributes of cancer follow-up were explored, overall and by cancer site.
Results: 668 (56.6%) recipients (132 melanoma; 213 breast; 158 prostate; 165 colorectal) responded. Cancer survivors had a strong preference to see a consultant during a face-to-face appointment when receiving cancer follow-up. However, cancer survivors appeared willing to accept follow-up from specialist nurses, registrars or GPs provided that they are compensated by increased continuity of care, dietary advice and one-to-one counselling. Longer appointments were also valued. Telephone and web-based follow-up and group counselling, were not considered desirable. Survivors of colorectal cancer and melanoma would see any alternative provider for greater continuity, whereas breast cancer survivors wished to see a registrar or specialist nurse, and prostate cancer survivors, a general practitioner.
Conclusion: Cancer survivors may accept non-consultant follow-up if compensated with changes elsewhere. Care continuity was sufficient compensation for most cancers. Given practicalities, costs, and the potential to develop continuous care, specialist nurse-led cancer follow-up may be attractive.

Original languageEnglish
Pages (from-to)1495-1503
Number of pages9
JournalBritish Journal of Cancer
Volume115
Issue number12
Early online date1 Nov 2016
DOIs
Publication statusPublished - 6 Dec 2016

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Aftercare
Survivors
Neoplasms
Melanoma
Continuity of Patient Care
Counseling
Colorectal Neoplasms
Prostatic Neoplasms
Appointments and Schedules
Breast Neoplasms
Scotland
Consultants
Telephone
Compensation and Redress
General Practitioners
Prostate
Breast

Keywords

  • cancer
  • survivorship
  • follow-up
  • primary care
  • discrete choice experiment
  • patient preferences

Cite this

Determining cancer survivors' preferences to inform new models of follow-up care. / Murchie, Peter; Norwood, Patricia F; Pietrucin-Materek, Marta; Porteous, Terry; Hannaford, Philip C; Ryan, Mandy.

In: British Journal of Cancer, Vol. 115, No. 12, 06.12.2016, p. 1495-1503.

Research output: Contribution to journalArticle

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title = "Determining cancer survivors' preferences to inform new models of follow-up care",
abstract = "Background: Specialist-led cancer follow-up is becoming increasingly expensive and is failing to meet many survivors’ needs. Alternative models informed by survivors’ preferences are urgently needed. It is unknown if follow-up preferences differ by cancer type. We conducted the first study to assess British cancer survivors’ follow-up preferences, and the first anywhere to compare preferences of survivors from different cancers.Methods: A discrete choice experiment questionnaire was mailed to 1,201 adults in Northeast Scotland surviving melanoma, breast, prostate or colorectal cancer. Preferences and trade-offs for attributes of cancer follow-up were explored, overall and by cancer site.Results: 668 (56.6{\%}) recipients (132 melanoma; 213 breast; 158 prostate; 165 colorectal) responded. Cancer survivors had a strong preference to see a consultant during a face-to-face appointment when receiving cancer follow-up. However, cancer survivors appeared willing to accept follow-up from specialist nurses, registrars or GPs provided that they are compensated by increased continuity of care, dietary advice and one-to-one counselling. Longer appointments were also valued. Telephone and web-based follow-up and group counselling, were not considered desirable. Survivors of colorectal cancer and melanoma would see any alternative provider for greater continuity, whereas breast cancer survivors wished to see a registrar or specialist nurse, and prostate cancer survivors, a general practitioner.Conclusion: Cancer survivors may accept non-consultant follow-up if compensated with changes elsewhere. Care continuity was sufficient compensation for most cancers. Given practicalities, costs, and the potential to develop continuous care, specialist nurse-led cancer follow-up may be attractive.",
keywords = "cancer, survivorship, follow-up, primary care, discrete choice experiment, patient preferences",
author = "Peter Murchie and Norwood, {Patricia F} and Marta Pietrucin-Materek and Terry Porteous and Hannaford, {Philip C} and Mandy Ryan",
note = "We wish to acknowledge the time taken by our participants in the study. We also thank: Amanda Cardy of the Scottish Primary Care Research Network who assisted MPM in administering the questionnaire mailings; Mrs Hazel Riley, CAPC, University of Aberdeen, who assisted MPM with data entry; Drs Graham Macdonald, Marianne Nicolson, Leslie Samuel and Radha Todd, cancer specialists working at Aberdeen Royal Infirmary, who supported us by generating lists of their clinic attendees and screening the lists of potential recipients; Dr Verity Watson, HERU, University of Aberdeen who provided advice and support to MPM in the conduct of the analysis.",
year = "2016",
month = "12",
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T1 - Determining cancer survivors' preferences to inform new models of follow-up care

AU - Murchie, Peter

AU - Norwood, Patricia F

AU - Pietrucin-Materek, Marta

AU - Porteous, Terry

AU - Hannaford, Philip C

AU - Ryan, Mandy

N1 - We wish to acknowledge the time taken by our participants in the study. We also thank: Amanda Cardy of the Scottish Primary Care Research Network who assisted MPM in administering the questionnaire mailings; Mrs Hazel Riley, CAPC, University of Aberdeen, who assisted MPM with data entry; Drs Graham Macdonald, Marianne Nicolson, Leslie Samuel and Radha Todd, cancer specialists working at Aberdeen Royal Infirmary, who supported us by generating lists of their clinic attendees and screening the lists of potential recipients; Dr Verity Watson, HERU, University of Aberdeen who provided advice and support to MPM in the conduct of the analysis.

PY - 2016/12/6

Y1 - 2016/12/6

N2 - Background: Specialist-led cancer follow-up is becoming increasingly expensive and is failing to meet many survivors’ needs. Alternative models informed by survivors’ preferences are urgently needed. It is unknown if follow-up preferences differ by cancer type. We conducted the first study to assess British cancer survivors’ follow-up preferences, and the first anywhere to compare preferences of survivors from different cancers.Methods: A discrete choice experiment questionnaire was mailed to 1,201 adults in Northeast Scotland surviving melanoma, breast, prostate or colorectal cancer. Preferences and trade-offs for attributes of cancer follow-up were explored, overall and by cancer site.Results: 668 (56.6%) recipients (132 melanoma; 213 breast; 158 prostate; 165 colorectal) responded. Cancer survivors had a strong preference to see a consultant during a face-to-face appointment when receiving cancer follow-up. However, cancer survivors appeared willing to accept follow-up from specialist nurses, registrars or GPs provided that they are compensated by increased continuity of care, dietary advice and one-to-one counselling. Longer appointments were also valued. Telephone and web-based follow-up and group counselling, were not considered desirable. Survivors of colorectal cancer and melanoma would see any alternative provider for greater continuity, whereas breast cancer survivors wished to see a registrar or specialist nurse, and prostate cancer survivors, a general practitioner.Conclusion: Cancer survivors may accept non-consultant follow-up if compensated with changes elsewhere. Care continuity was sufficient compensation for most cancers. Given practicalities, costs, and the potential to develop continuous care, specialist nurse-led cancer follow-up may be attractive.

AB - Background: Specialist-led cancer follow-up is becoming increasingly expensive and is failing to meet many survivors’ needs. Alternative models informed by survivors’ preferences are urgently needed. It is unknown if follow-up preferences differ by cancer type. We conducted the first study to assess British cancer survivors’ follow-up preferences, and the first anywhere to compare preferences of survivors from different cancers.Methods: A discrete choice experiment questionnaire was mailed to 1,201 adults in Northeast Scotland surviving melanoma, breast, prostate or colorectal cancer. Preferences and trade-offs for attributes of cancer follow-up were explored, overall and by cancer site.Results: 668 (56.6%) recipients (132 melanoma; 213 breast; 158 prostate; 165 colorectal) responded. Cancer survivors had a strong preference to see a consultant during a face-to-face appointment when receiving cancer follow-up. However, cancer survivors appeared willing to accept follow-up from specialist nurses, registrars or GPs provided that they are compensated by increased continuity of care, dietary advice and one-to-one counselling. Longer appointments were also valued. Telephone and web-based follow-up and group counselling, were not considered desirable. Survivors of colorectal cancer and melanoma would see any alternative provider for greater continuity, whereas breast cancer survivors wished to see a registrar or specialist nurse, and prostate cancer survivors, a general practitioner.Conclusion: Cancer survivors may accept non-consultant follow-up if compensated with changes elsewhere. Care continuity was sufficient compensation for most cancers. Given practicalities, costs, and the potential to develop continuous care, specialist nurse-led cancer follow-up may be attractive.

KW - cancer

KW - survivorship

KW - follow-up

KW - primary care

KW - discrete choice experiment

KW - patient preferences

U2 - 10.1038/bjc.2016.352

DO - 10.1038/bjc.2016.352

M3 - Article

VL - 115

SP - 1495

EP - 1503

JO - British Journal of Cancer

JF - British Journal of Cancer

SN - 0007-0920

IS - 12

ER -