Chopra Ishveen, Chopra Avijeet
Department of Pharmacy Administration, Duquesne University, Pittsburgh, PA, USA.
Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, USA.
Patient Relat Outcome Meas. 2014 Aug 30;5:71-85. doi: 10.2147/PROM.S49586. eCollection 2014.
Appropriate follow-up care is important for improving health outcomes in breast cancer survivors (BCSs) and requires determination of the optimum intensity of clinical examination and surveillance, assessment of models of follow-up care such as primary care-based follow-up, an understanding of the goals of follow-up care, and unique psychosocial aspects of care for these patients. The objective of this systematic review was to identify studies focusing on follow-up care in BCSs from the patient's and physician's perspective or from patterns of care and to integrate primary empirical evidence on the different aspects of follow-up care from these studies.
A comprehensive literature review and evaluation was conducted for all relevant publications in English from January 1, 1990 to December 31, 2013 using electronic databases. Studies were included in the final review if they focused on BCS's preferences and perceptions, physician's perceptions, patterns of care, and effectiveness of follow-up care.
A total of 47 studies assessing the different aspects of follow-up care were included in the review, with a majority of studies (n=13) evaluating the pattern of follow-up care in BCSs, followed by studies focusing on BCS's perceptions (n=9) and preferences (n=9). Most of the studies reported variations in recommended frequency, duration, and intensity of follow-up care as well as frequency of mammogram screening. In addition, variations were noted in patient preferences for type of health care provider (specialist versus non-specialist). Further, BCSs perceived a lack of psychosocial support and information for management of side effects.
The studies reviewed, conducted in a range of settings, reflect variations in different aspects of follow-up care. Further, this review also provides useful insight into the unique concerns and needs of BCSs for follow-up care. Thus, clinicians and decision-makers need to understand BCS's preferences in providing appropriate follow-up care tailored specifically for each patient.
适当的后续护理对于改善乳腺癌幸存者（BCS）的健康结局至关重要，这需要确定临床检查和监测的最佳强度，评估基于初级保健的后续护理等后续护理模式，理解后续护理的目标，以及了解这些患者护理中独特的心理社会方面。本系统评价的目的是从患者和医生的角度或护理模式方面识别关注BCS后续护理的研究，并整合这些研究中关于后续护理不同方面的主要实证证据。
使用电子数据库对1990年1月1日至2013年12月31日期间所有相关英文出版物进行了全面的文献综述和评估。如果研究关注BCS的偏好和认知、医生的认知、护理模式以及后续护理的有效性，则纳入最终综述。
共有47项评估后续护理不同方面的研究纳入了该综述，其中大多数研究（n = 13）评估了BCS的后续护理模式，其次是关注BCS认知（n = 9）和偏好（n = 9）的研究。大多数研究报告了推荐的后续护理频率、持续时间和强度以及乳房X光筛查频率的差异。此外，还注意到患者对医疗服务提供者类型（专科医生与非专科医生）的偏好存在差异。此外，BCS认为在副作用管理方面缺乏心理社会支持和信息。
在一系列环境中进行的综述研究反映了后续护理不同方面的差异。此外，本综述还为BCS在后续护理方面的独特关注点和需求提供了有用的见解。因此，临床医生和决策者需要了解BCS在提供针对每个患者的适当后续护理方面的偏好。
