title: Open access follow-up care for early breast cancer: a randomised controlled quality of life analysis.
abstract: This study evaluated the acceptability of a supportive model of follow-up. One hundred and twelve women recovering from breast cancer were randomised to receive standard breast clinic aftercare (Control n = 56) or on demand by open access aftercare by breast care nurses (Intervention n = 56). Participants attended a support-based psycho-educational programme delivered in four half-day group sessions. Three quality of life questionnaires (EORTC QLQ-C30, QLQ-BR23, HADS) were administered at baseline and 6-monthly intervals for 2 years. Multilevel linear regression modelling methods were used for evaluation. Age was found to be a statistically significant predictor of quality of life in several sub-scales. Increasing age was negatively associated with sexual functioning, systematic therapy side effects and physical functioning, and positively associated with future perspective. Aftercare assignment was not found to be a statistically significant predictor. Women treated for early breast cancer were not disadvantaged by allocation to the open access supportive care model in terms of quality of life experienced. The model for follow-up was demonstrated to be a feasible alternative to routinised hospital-based follow-up and adds to the evidence for stratified follow-up for low-risk cancer patients, incorporating self-management education. Stratified follow-up pathways are viewed as a preferable approach.
authors.affiliation: School of Health, Faculty of Engineering, Health, Science and the Environment, Charles Darwin University, Darwin, Casuarina, Northern Territory, Australia.
authors.forename: M N
authors.initials: MN
authors.lastname: Kirshbaum
authors.affiliation: The Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, West Yorkshire, UK.
authors.forename: J
authors.initials: J
authors.lastname: Dent
authors.affiliation: University of Huddersfield, Huddersfield, UK.
authors.forename: J
authors.initials: J
authors.lastname: Stephenson
authors.affiliation: Hamad Medical Corporation, Doha, Qaatar.
authors.forename: A E
authors.initials: AE
authors.lastname: Topping
authors.affiliation: The Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, West Yorkshire, UK.
authors.forename: V
authors.initials: V
authors.lastname: Allinson
authors.affiliation: Breast Cancer Care, Sheffield, UK.
authors.forename: M
authors.initials: M
authors.lastname: McCoy
authors.affiliation: Breast Cancer Care, Sheffield, UK.
authors.forename: S
authors.initials: S
authors.lastname: Brayford
mesh_terms: D000328:Adult; D000359:Aftercare / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000628:therapy; D010353:Patient Education as Topic / Q000379:methods; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires
keywords: breast cancer; psychological; quality of life; supportive care