title: Outreach monitoring service for patients with indolent B-cell and plasma cell disorders: a UK experience.
abstract: Disease progression occurs in over 1% of monoclonal gammopathy of undetermined significance, monoclonal B-cell lymphocytosis and early stage chronic lymphocytic leukaemia patients every year therefore regular monitoring is indicated. We assessed the efficacy of an outreach service to replace clinic monitoring using local phlebotomy with central haematologist review of laboratory parameters and symptoms identified by a patient self-assessment questionnaire. The service was used by 299 patients for 2 years and provided accurate monitoring, improved patient satisfaction, support for primary care and reduced the burden on haematology clinics without an increase in inter-assessment admissions due to disease progression.
authors.affiliation: HMDS Department, Leeds Teaching Hospitals, Leeds, UK. andy.rawstron@hmds.org.uk
authors.forename: Andy C
authors.initials: AC
authors.lastname: Rawstron
authors.forename: Richard A
authors.initials: RA
authors.lastname: Jones
authors.forename: Carol
authors.initials: C
authors.lastname: Ferguson
authors.forename: Geraint
authors.initials: G
authors.lastname: Hughes
authors.forename: Pam
authors.initials: P
authors.lastname: Selby
authors.forename: Carol
authors.initials: C
authors.lastname: Reid
authors.forename: Surita
authors.initials: S
authors.lastname: Dalal
authors.forename: Martin
authors.initials: M
authors.lastname: Howard
authors.forename: Graeme
authors.initials: G
authors.lastname: Smith
authors.forename: Peter
authors.initials: P
authors.lastname: Hillmen
authors.forename: Roger G
authors.initials: RG
authors.lastname: Owen
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Jack
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration; D001402:B-Lymphocytes; D003153:Community Health Services / Q000458:organization & administration; D004739:England; D005194:Family Practice / Q000458:organization & administration; D006405:Hematology / Q000458:organization & administration; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy*; D008218:Lymphocytosis / Q000628:therapy*; D008991:Monitoring, Physiologic / Q000379:methods*; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000473:pathology / Q000628:therapy*; D010336:Pathology / Q000458:organization & administration; D010348:Patient Care Team; D017060:Patient Satisfaction; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration; D012017:Referral and Consultation