Comparison of breast cancer patient satisfaction with follow-up in primary care versus specialist care: results from a randomized controlled trial.
BACKGROUND
Routine follow-up of breast cancer patients in specialist clinics is standard practice in most countries. Follow-up involves regularly scheduled breast cancer check-ups during the disease-free period. The aims of follow-up are to detect breast cancer recurrence and to provide psychosocial support to the patient; however, little is known about patients' views on breast cancer follow-up.


OBJECTIVE
To assess the effect on patient satisfaction of transferring primary responsibility for follow-up of women with breast cancer in remission from hospital outpatient clinics to general practice.


METHODS
Randomized controlled trial with 18 months' follow-up in which women received routine follow-up either in hospital outpatient clinics or from their own general practitioner. Two hundred and ninety-six women with breast cancer in remission receiving regular follow-up care at two district general hospitals in England were included in the study. Patient satisfaction was measured by means of a self-administered questionnaire supplied three times during the 18-month study period.


RESULTS
The general practice group selected responses indicating greater satisfaction than did the hospital group on virtually every question. Furthermore, in the general practice group there was a significant increase in satisfaction over baseline; a similar significant increase in satisfaction over baseline was not found in the hospital group.


CONCLUSIONS
Patients with breast cancer were more satisfied with follow-up in general practice than in hospital outpatient departments. When discussing follow-up with breast cancer patients, they should be provided with complete and accurate information about the goals, expectations, and limitations of the follow-up programme so that they can make an informed choice.
Grunfeld
E
E
Division of Public Health and Primary Health Care, Institute of Health Sciences, Headington, Oxford. egrunfeld@cancercare.on.ca
Fitzpatrick
R
R
Mant
D
D
Yudkin
P
P
Adewuyi-Dalton
R
R
Stewart
J
J
Cole
D
D
Vessey
M
M
D000553:Ambulatory Care; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003695:Delivery of Health Care; D004739:England; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017060:Patient Satisfaction; D011320:Primary Health Care; D012008:Recurrence; D011795:Surveys and Questionnaires