Urology Department, Strasbourg University Hospital, 1, place de l'Hôpital, 67000, Strasbourg, France.
Support Care Cancer. 2022 Sep;30(9):7293-7302. doi: 10.1007/s00520-022-07151-x. Epub 2022 May 23.
New follow-up models of care are needed to ensure long-term comprehensive care for cancer survivors. We investigated the impact of a general practitioner (GP)-led follow-up program for prostate cancer (PCa) and renal cell cancer (RCC) survivors.
This retrospective monocentric study compared standard urologist-led follow-up to experimental GP-led follow-up within a nurse-led network for PCa and RCC survivors. To assess the safe continuity of follow-up, the number of patients lost to follow-up (LFU) was collected. A microcosting analysis from the French national health system perspective was conducted to describe incremental costs associated with experimental follow-up. A satisfaction survey was conducted to determine participating patient's and GP's satisfaction scores, ranging from 0 to 4 and 0 to 5, respectively.
Among the 1274 patients included, 92/753 (12.2%) were LFU during standard follow-up vs 0/521 (0%) during experimental follow-up (p < 0.001). In the latter, the median management delay of suspected recurrence for PCa and RCC survivors was 20 [12-27] and 16 [10.5-31.25] days, and the mean incremental cost on a per-patient basis was 34.68 ± 105.87€ and 64.24 ± 93.55€, respectively. Patient and GP mean satisfaction scores were 3.6/4 and 3.9/5, respectively.
The GP-led follow-up of PCa and RCC survivors within a nurse-led network seems to provide safe continuity of follow-up and seems not to be associated with major incremental costs. The surveys indicated high level of patient's satisfaction and encouraging results regarding GP's satisfaction. Randomized clinical trials are needed to confirm these findings and promote larger implementation of this type of follow-up care.
需要新的随访模式来确保癌症幸存者的长期综合护理。我们研究了由全科医生（GP）主导的前列腺癌（PCa）和肾细胞癌（RCC）幸存者随访方案的影响。
本回顾性单中心研究比较了标准泌尿科医生主导随访与 PCa 和 RCC 幸存者护士主导网络中的实验性 GP 主导随访。为了评估随访的安全连续性，收集了失访（LFU）患者的数量。从法国国家卫生系统的角度进行了微观成本分析，以描述与实验性随访相关的增量成本。进行了一项满意度调查，以确定参与患者和 GP 的满意度评分，范围分别为 0 到 4 和 0 到 5。
在纳入的 1274 名患者中，92/753 名（12.2%）在标准随访中 LFU，而 0/521 名（0%）在实验性随访中 LFU（p<0.001）。在后一种情况下，疑似复发的 PCa 和 RCC 幸存者的中位管理延迟为 20 [12-27] 和 16 [10.5-31.25] 天，每位患者的平均增量成本分别为 34.68 ± 105.87€和 64.24 ± 93.55€。患者和 GP 的平均满意度评分为 3.6/4 和 3.9/5。
在护士主导的网络中，由 GP 主导的 PCa 和 RCC 幸存者的随访似乎提供了安全的连续性，并且似乎不会带来重大的增量成本。调查表明患者满意度较高，并且 GP 的满意度结果令人鼓舞。需要进行随机临床试验来证实这些发现，并促进这种随访护理模式的更大实施。
