Batehup L, Porter K, Gage H, Williams P, Simmonds P, Lowson E, Dodson L, Davies N J, Wagland R, Winter J D, Richardson A, Turner A, Corner J L
Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK.
School of Economics, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
Support Care Cancer. 2017 Jul;25(7):2063-2073. doi: 10.1007/s00520-017-3595-x. Epub 2017 Feb 14.
To compare patient-triggered follow-up (PTFU) for curatively treated colorectal cancer against traditional outpatient follow-up (OPFU).
Questionnaires were mailed at four time points over one-year post-treatment to two prospectively-recruited cohorts: A, patients entering follow-up and receiving OPFU pre-implementation of PTFU; B, patients entering follow-up (FU) and receiving either OPFU (B1) or PTFU (B2) post-implementation of PTFU. Bi-variate tests were used to compare patient characteristics and outcomes eight months after entering follow-up (generic and cancer-specific quality of life (QoL), satisfaction). Regression analysis explored associations between follow-up model and outcomes. Resource implications and costs of models were compared.
Patients in Cohort B1 were significantly more likely to have received chemotherapy (p < 0.001), radiotherapy (p < 0.05), and reported poorer QoL (p = 0.001). Having a longstanding co-morbid condition was the most important determinant of QoL (p < 0.001); model of care was not significant. Patients were satisfied with their follow-up care regardless of model. Health service costs were higher in PTFU over the first year CONCLUSIONS: PTFU is acceptable to patients with colorectal cancer and can be considered to be a realistic alternative to OPFU for clinically suitable patients. The initial costs are higher due to provision of a self-management (SM) programme and remote surveillance. Further research is needed to establish long-term outcomes and costs.
比较根治性治疗的结直肠癌患者触发式随访（PTFU）与传统门诊随访（OPFU）。
在治疗后一年的四个时间点，向前瞻性招募的两个队列邮寄问卷：队列A，在PTFU实施前进入随访并接受OPFU的患者；队列B，在PTFU实施后进入随访（FU）并接受OPFU（B1）或PTFU（B2）的患者。使用双变量检验比较进入随访八个月后的患者特征和结局（一般和癌症特异性生活质量（QoL）、满意度）。回归分析探讨随访模式与结局之间的关联。比较了两种模式的资源影响和成本。
队列B1中的患者接受化疗（p < 0.001）、放疗（p < 0.05）的可能性显著更高，且生活质量较差（p = 0.001）。患有长期并存疾病是生活质量的最重要决定因素（p < 0.001）；护理模式不显著。无论采用何种模式，患者对其随访护理都感到满意。第一年PTFU的卫生服务成本更高。结论：PTFU对于结直肠癌患者是可以接受的，对于临床合适的患者可被视为OPFU的一种现实替代方案。由于提供自我管理（SM）计划和远程监测，初始成本较高。需要进一步研究以确定长期结局和成本。
