Audit of effectiveness of routine follow-up clinics after radiotherapy for cancer: a report of the REACT working group of ESTRO.
OBJECTIVE
The European Society for Therapeutic Radiology and Oncology was funded by the EU for a project on recording providing education, and ameliorating the consequences of treatment (REACT). An European audit was carried out as part of which to assess the usefulness of current follow-up practices.


METHODS
Over a 4-month period in 15 cancer centres in 10 countries, patients attending for routine follow-up completed a questionnaire covering their expectations of and satisfaction with the visit. This was matched with a questionnaire completed by the physician about the content and usefulness of the consultation. The feasibility of a short toxicity scale developed by Dische and Saunders was also investigated.


RESULTS
In total, 2303 matched questionnaires were analysed. Forty percent of the patients had symptoms or medical problems related to their disease. In 18% there was a positive finding on clinical examination. In 28% investigations were undertaken part of departmental routine practice. Ten percent of the investigations showed an abnormal result. Ninety nine percent of physicians and 85% of the patients expressed satisfaction. Using the short toxicity scale rates of recording toxicity could be increased from 28 to 93%.


CONCLUSIONS
There is wide variation in follow-up practices among European centres. There was a low incidence of positive findings clinically or with routine investigations. A simple scale for recording morbidity has proved easy to use by departments, which have not routinely used one of the standard measures. Further work will attempt to produce an European guideline for effective routine follow-up after radiotherapy.
Ataman
Ozlem Uruk
OU
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK.
Barrett
Ann
A
Davidson
Susan
S
De Haas-Kock
Danielle
D
Dische
Stanley
S
Dubray
Bernard
B
Grillo
Isabel M
IM
Kramar
Andrew
A
Haie-Meder
Christine
C
Heeren
Germaine
G
Hideghety
Katalin
K
LeVay
John
J
Maher
Jane
J
Marcenaro
Michela
M
Muller
Rolf-Peter
RP
Reguerio
Carlos A
CA
Saunders
Michele I
MI
Turesson
Ingela
I
Van Houtte
Paul
P
Vitale
Vito
V
D000554:Ambulatory Care Facilities; D002173:Cancer Care Facilities / Q000592:standards*; D003266:Continuity of Patient Care / Q000592:standards*; D003955:Diagnostic Tests, Routine; D005060:Europe; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D008485:Medical Audit; D009369:Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D017060:Patient Satisfaction; D011787:Quality of Health Care; D018787:Radiation Oncology / Q000592:standards*; D011795:Surveys and Questionnaires