Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, DK-7100, Vejle, Denmark.
Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
J Cancer Surviv. 2021 Aug;15(4):485-496. doi: 10.1007/s11764-020-00942-3. Epub 2021 Jan 7.
The increasing population of breast cancer survivors highlights the need to (re)consider how we utilize available services for survivorship care in oncology clinics. Electronic Patient-Reported Outcomes (ePROs) can be used to identify patients' individual care needs and triage them to the right services. We examined the impact on service use, workflow and workload following the introduction of an ePRO-based individual follow-up (PIFU) for women treated for early breast cancer.
A multi-method approach was used. In a pilot randomized controlled trial, the use of consultations, telephone calls, and specialist referrals were systematically recorded. Comparison was done between PIFU and standard follow-up care (SFU). Focus group interviews with nurse navigators evaluated the impact on workflow and workload qualitatively.
The 64 women randomized to attend SFU used a mean of 3.8 (95% CI: 3.5-4.1) planned consultations during the 2-year study period compared with a mean of 1.9 consultations (95% CI: 1.4-2.4) for the 60 women randomized to PIFU (P < 0.001). Urgent appointments were more frequent in SFU (mean of 0.47 vs 0.22 per patient, P = 0.03). No statistically significant differences were observed in the use of telephone calls and specialist referrals. The nurse navigators did not experience an increase in their workload, but implementation of PIFU may require a re-structured workflow.
The ePRO-based individual follow-up could change organization of care and re-allocate services for those in need of it.
ePRO-based individual follow-up could potentially ensure more time for those most in need of face-to-face care.
乳腺癌幸存者人数的增加凸显了我们需要重新考虑如何在肿瘤诊所利用现有服务进行生存护理。电子患者报告结局（ePRO）可用于确定患者的个体护理需求，并将其分诊至合适的服务。我们研究了在为早期乳腺癌患者实施基于 ePRO 的个体化随访（PIFU）后，对服务利用、工作流程和工作量的影响。
采用多方法学方法。在一项试点随机对照试验中，系统地记录了咨询、电话和专家转诊的使用情况。比较了 PIFU 和标准随访护理（SFU）。对护士导航员进行焦点小组访谈，定性评估对工作流程和工作量的影响。
在 2 年的研究期间，随机分配至 SFU 的 64 名女性平均使用了 3.8（95%CI：3.5-4.1）次计划咨询，而随机分配至 PIFU 的 60 名女性平均使用了 1.9 次咨询（95%CI：1.4-2.4）（P<0.001）。SFU 中紧急预约更频繁（每位患者平均 0.47 次与 0.22 次，P=0.03）。电话咨询和专家转诊的使用无统计学显著差异。护士导航员的工作量没有增加，但实施 PIFU 可能需要重新构建工作流程。
基于 ePRO 的个体化随访可以改变护理组织，并重新分配服务给有需要的人。
基于 ePRO 的个体化随访可以确保更多时间为最需要面对面护理的人提供服务。
