Patients' and healthcare professionals' views of cancer follow-up: systematic review.
BACKGROUND
Cancer follow-up places a significant burden on hospital outpatient clinics. There are increasing calls to develop alternative models of provision.


OBJECTIVE
To undertake a systematic review of qualitative studies examining patients' and healthcare professionals' views about cancer follow-up.


METHODS
Systematic review.


METHODS
Primary and secondary care.


METHODS
Comprehensive literature searches included: 19 electronic databases, online trial registries, conference proceedings, and bibliographies of included studies. Eligible studies included qualitative studies examining patients' and healthcare professionals' views of cancer follow-up. Studies of patients with any type of cancer, considered free of active disease, or no longer receiving active treatment were included. Findings were synthesised using thematic analysis.


RESULTS
Nineteen studies were included; seven were linked to randomised controlled trials. Eight studies examined the views of healthcare professionals (four of which included GPs) and 16 examined the views of patients. Twelve descriptive themes were identified, from which 12 perceived implications for practice were derived. Most themes related to conventional follow-up in secondary care. Some views concerning other models of care were based on participants' ideas, rather than experiences.


CONCLUSIONS
Patients' main concern is recurrent disease, and they find regular follow-up, expertise of specialists, and quick access to tests reassuring. Information regarding the effectiveness of follow-up is not given to patients who also have unmet information needs, which would help them to cope and be more involved. Continuity of care, unhurried consultations, and psychosocial support are important, but sometimes lacking in secondary care. GPs are thought to be unwilling and to have insufficient time and expertise to conduct follow-up.
Lewis
Ruth A
RA
Department of Primary Care and Public Health, North Wales Clinical School, School of Medicine, Cardiff University, Wrexham. lewisr17@cf.ac.uk
Neal
Richard D
RD
Hendry
Maggie
M
France
Barbara
B
Williams
Nefyn H
NH
Russell
Daphne
D
Hughes
Dyfrig A
DA
Russell
Ian
I
Stuart
Nicholas S A
NS
Weller
David
D
Wilkinson
Clare
C
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000592:standards; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D017060:Patient Satisfaction; D016032:Randomized Controlled Trials as Topic