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Nurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial

Nurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial
Nurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial
Objective: To assess the effectiveness of nurse led follow up in the management of patients with lung cancer.
Design: Randomised controlled trial.
Setting: Specialist cancer hospital and three cancer units in southeastern England.
Participants: 203 patients with lung cancer who had completed their initial treatment and were expected to survive for at least 3 months.
Intervention: Nurse led follow up of outpatients compared with conventional medical follow up.
Outcome measures: Quality of life, patients' satisfaction, general practitioners' satisfaction, survival, symptom-free survival, progression-free survival, use of resources, and comparison of costs.
Results: Patient acceptability of nurse led follow up was high: 75% (203/271) of eligible patients consented to participate. Patients who received the intervention had less severe dyspnoea at 3 months (P=0.03) and had better scores for emotional functioning (P=0.03) and less peripheral neuropathy (P=0.05) at 12 months. Intervention group patients scored significantly better in most satisfaction subscales at 3, 6, and 12 months (P<0.01 for all subscales at 3 months). No significant differences in general practitioners' overall satisfaction were seen between the two groups. No differences were seen in survival or rates of objective progression, although nurses recorded progression of symptoms sooner than doctors (P=0.01). Intervention patients were more likely to die at home rather than in a hospital or hospice (P=0.04), attended fewer consultations with a hospital doctor during the first 3 months (P=0.004), had fewer radiographs during the first 6 months (P=0.04), and had more radiotherapy within the first 3 months (P=0.01). No other differences were seen between the two groups in terms of the use of resources.
Conclusion: Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes.
lung cancer, management of patients, nurse led, conventional medical, followup
0959-8138
1145-1147
Moore, S.
e2074928-5d57-49c1-9006-319969f572c8
Corner, J.
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa
Haviland, J.
3857460b-05c8-4bcb-b9de-8e511063d220
Wells, M.
e36f98e6-36ef-4fec-8fd5-9402faf02d6c
Salmon, E.
4ff2e623-dd6f-4248-9eb6-9e16d073637f
Normand, C.
f8307c24-2875-4b85-89f6-c356dee0cba0
Brada, M.
d2fa8151-d3c5-42c4-b4c5-c0fe635c51bc
O'Brien, M.
8f471ec3-2a15-4f39-a1f8-d0c485b102e3
Smith, I.
38ff017c-f425-4264-9f2a-7a4dec0e164d
Moore, S.
e2074928-5d57-49c1-9006-319969f572c8
Corner, J.
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa
Haviland, J.
3857460b-05c8-4bcb-b9de-8e511063d220
Wells, M.
e36f98e6-36ef-4fec-8fd5-9402faf02d6c
Salmon, E.
4ff2e623-dd6f-4248-9eb6-9e16d073637f
Normand, C.
f8307c24-2875-4b85-89f6-c356dee0cba0
Brada, M.
d2fa8151-d3c5-42c4-b4c5-c0fe635c51bc
O'Brien, M.
8f471ec3-2a15-4f39-a1f8-d0c485b102e3
Smith, I.
38ff017c-f425-4264-9f2a-7a4dec0e164d

Moore, S., Corner, J., Haviland, J., Wells, M., Salmon, E., Normand, C., Brada, M., O'Brien, M. and Smith, I. (2002) Nurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial. BMJ, 325 (7373), 1145-1147. (doi:10.1136/bmj.325.7373.1145).

Record type: Article

Abstract

Objective: To assess the effectiveness of nurse led follow up in the management of patients with lung cancer.
Design: Randomised controlled trial.
Setting: Specialist cancer hospital and three cancer units in southeastern England.
Participants: 203 patients with lung cancer who had completed their initial treatment and were expected to survive for at least 3 months.
Intervention: Nurse led follow up of outpatients compared with conventional medical follow up.
Outcome measures: Quality of life, patients' satisfaction, general practitioners' satisfaction, survival, symptom-free survival, progression-free survival, use of resources, and comparison of costs.
Results: Patient acceptability of nurse led follow up was high: 75% (203/271) of eligible patients consented to participate. Patients who received the intervention had less severe dyspnoea at 3 months (P=0.03) and had better scores for emotional functioning (P=0.03) and less peripheral neuropathy (P=0.05) at 12 months. Intervention group patients scored significantly better in most satisfaction subscales at 3, 6, and 12 months (P<0.01 for all subscales at 3 months). No significant differences in general practitioners' overall satisfaction were seen between the two groups. No differences were seen in survival or rates of objective progression, although nurses recorded progression of symptoms sooner than doctors (P=0.01). Intervention patients were more likely to die at home rather than in a hospital or hospice (P=0.04), attended fewer consultations with a hospital doctor during the first 3 months (P=0.004), had fewer radiographs during the first 6 months (P=0.04), and had more radiotherapy within the first 3 months (P=0.01). No other differences were seen between the two groups in terms of the use of resources.
Conclusion: Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes.

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More information

Published date: November 2002
Keywords: lung cancer, management of patients, nurse led, conventional medical, followup

Identifiers

Local EPrints ID: 9488
URI: http://eprints.soton.ac.uk/id/eprint/9488
ISSN: 0959-8138
PURE UUID: d8079c1e-fc72-40e0-99e0-a656eb84e628

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Date deposited: 05 Oct 2004
Last modified: 15 Mar 2024 04:55

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Contributors

Author: S. Moore
Author: J. Corner
Author: J. Haviland
Author: M. Wells
Author: E. Salmon
Author: C. Normand
Author: M. Brada
Author: M. O'Brien
Author: I. Smith

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