An audit of follow-up clinics for breast cancer patients in Cornwall: is the time and effort worth it?
This paper's aims were to investigate the time and costs of healthcare professionals involved with follow-up clinics for breast cancer patients; and to quantify the numbers of local recurrences detected. An audit of breast cancer patients diagnosed with disease recurrence was conducted, and data were collected from the cancer audit system and from an analysis of relevant case notes. Costs of the time spent in follow-up clinics by clinical staff were also collected. The study found that sixty-nine breast cancer patients were diagnosed with local recurrence between 1 January 1999 and 31 December 2004. Only 15% (10) of recurrences were detected at routine follow up, 48% were first noticed by patients themselves, and 37% were detected at routine mammography. Six separate follow-up clinics were scheduled each week. This involved a total clinic time of approximately 20 h, and a total weekly cost of around pound 4857, with an annual cost of pound 252,564. Our recommendation is that alternative methods of follow up need to be implemented so that healthcare professionals have more time for newly diagnosed patients, those on active treatment and those with relapsed disease.
Morris
J
J
Faculty of Health & Social Work, University of Plymouth, Knowledge Spa, Truro, UK. jmmorris@plymouth.ac.uk
Wheatley
D
D
Ingram
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics*; D003266:Continuity of Patient Care / Q000191:economics*; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000191:economics*; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000191:economics*; D009367:Neoplasm Staging