title: Nurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial.
abstract: OBJECTIVE
  To assess the effectiveness of nurse led follow up in the management of patients with lung cancer.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Specialist cancer hospital and three cancer units in southeastern England.
  
  
  METHODS
  203 patients with lung cancer who had completed their initial treatment and were expected to survive for at least 3 months.
  
  
  METHODS
  Nurse led follow up of outpatients compared with conventional medical follow up.
  
  
  METHODS
  Quality of life, patients' satisfaction, general practitioners' satisfaction, survival, symptom-free survival, progression-free survival, use of resources, and comparison of costs.
  
  
  RESULTS
  Patient acceptability of nurse led follow up was high: 75% (203/271) of eligible patients consented to participate. Patients who received the intervention had less severe dyspnoea at 3 months (P=0.03) and had better scores for emotional functioning (P=0.03) and less peripheral neuropathy (P=0.05) at 12 months. Intervention group patients scored significantly better in most satisfaction subscales at 3, 6, and 12 months (P<0.01 for all subscales at 3 months). No significant differences in general practitioners' overall satisfaction were seen between the two groups. No differences were seen in survival or rates of objective progression, although nurses recorded progression of symptoms sooner than doctors (P=0.01). Intervention patients were more likely to die at home rather than in a hospital or hospice (P=0.04), attended fewer consultations with a hospital doctor during the first 3 months (P=0.004), had fewer radiographs during the first 6 months (P=0.04), and had more radiotherapy within the first 3 months (P=0.01). No other differences were seen between the two groups in terms of the use of resources.
  
  
  CONCLUSIONS
  Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes.
authors.affiliation: Centre for Cancer and Palliative Care Studies, Institute of Cancer Research, Royal Marsden Hospital, London SW3 6JJ.
authors.forename: Sally
authors.initials: S
authors.lastname: Moore
authors.forename: Jessica
authors.initials: J
authors.lastname: Corner
authors.forename: Jo
authors.initials: J
authors.lastname: Haviland
authors.forename: Mary
authors.initials: M
authors.lastname: Wells
authors.forename: Emma
authors.initials: E
authors.lastname: Salmon
authors.forename: Charles
authors.initials: C
authors.lastname: Normand
authors.forename: Mike
authors.initials: M
authors.lastname: Brada
authors.forename: Mary
authors.initials: M
authors.lastname: O'Brien
authors.forename: Ian
authors.initials: I
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D005194:Family Practice / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life