title: Developing and piloting a nurse-led model of follow-up in the multidisciplinary management of colorectal cancer.
abstract: One of the main challenges of colorectal cancer follow-up is the detection of early disease in order to influence survival and improve outcome. Yet, the benefits of follow-up are not only related to survival. It is well documented that patients can experience an array of problems following colorectal cancer surgery which impact upon quality of life, therefore symptom management plays an important part in the overall spectrum of follow-up care. In addition, there is emerging evidence to suggest that clinical nurse specialists are well placed in the multidisciplinary team to co-ordinate such follow-up programmes. This paper reports on a pilot study designed to assess the feasibility of a follow-up programme led by nurse specialists for patients with colorectal cancer. Key outcome areas were adherence to an agreed follow-protocol, quality of life, patient and clinician satisfaction and a cost-analysis of the new model. The study was conducted over one year with 60 patients. This redesign resulted in a smoother pathway of follow-up care, improved quality of life and acceptance to both patients and clinicians alike. The introduction of a nurse-led follow-up model is expected to demonstrate cost savings over a 3 year rolling follow-up programme.
authors.affiliation: Edinburgh Cancer Centre, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, UK. gillian.knowles@scotland.gsi.gov.uk
authors.forename: Gillian
authors.initials: G
authors.lastname: Knowles
authors.forename: Linda
authors.initials: L
authors.lastname: Sherwood
authors.forename: Malcom G
authors.initials: MG
authors.lastname: Dunlop
authors.forename: Gail
authors.initials: G
authors.lastname: Dean
authors.forename: Duncan
authors.initials: D
authors.lastname: Jodrell
authors.forename: Catriona
authors.initials: C
authors.lastname: McLean
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Preston
mesh_terms: D000328:Adult; D000359:Aftercare / Q000458:organization & administration*; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D017046:Cost Savings; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009720:Nurse Clinicians / Q000458:organization & administration*; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D009859:Oncology Nursing / Q000458:organization & administration*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010348:Patient Care Team / Q000458:organization & administration*; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D012606:Scotland