Journal
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
Volume 124, Issue 1, Pages 150-160Publisher
WILEY
DOI: 10.1111/1471-0528.14000
Keywords
Endometrial cancer; gynaecology; oncology; patient satisfaction; psychological; morbidity; telephone follow-up
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Funding
- National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) programme [PB-PG-0610-22123]
- National Institutes of Health Research (NIHR) [PB-PG-0610-22123] Funding Source: National Institutes of Health Research (NIHR)
- Medical Research Council [MR/K025643/1] Funding Source: researchfish
- National Institute for Health Research [PB-PG-0610-22123] Funding Source: researchfish
- MRC [MR/K025643/1] Funding Source: UKRI
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Objective To evaluate the effectiveness of nurse-led telephone follow-up (TFU) for patients with stage-I endometrial cancer. Design Multicentre, randomised, non-inferiority trial. Setting Five centres in the North West of England. Sample A cohort of 259 women treated for stage-I endometrial cancer attending hospital outpatient clinics for routine follow-up. Methods Participants were randomly allocated to receive traditional hospital based follow-up (HFU) or nurse-led TFU. Main outcome measures Primary outcomes were psychological morbidity (State Trait Anxiety Inventory, STAI-S) and patient satisfaction with the information provided. Secondary outcomes included patient satisfaction with service, quality of life, and time to detection of recurrence. Results The STAI-S scores post-randomisation were similar between groups [ mean (SD): TFU 33.0 (11.0); HFU 35.5 (13.0)]. The estimated between-group difference in STAI-S was 0.7 (95% confidence interval, 95% CI -1.9 to 3.3); the confidence interval lies above the non-inferiority limit (-3.5), indicating the non-inferiority of TFU. There was no significant difference between groups in reported satisfaction with information (odds ratio, OR 0.9; 95% CI 0.4-2.1; P = 0.83). Women in the HFU group were more likely to report being kept waiting for their appointment (P = 0.001), that they did not need any information (P = 0.003), and were less likely to report that the nurse knew about their particular case and situation (P = 0.005). Conclusions The TFU provides an effective alternative to HFU for patients with stage-I endometrial cancer, with no reported physical or psychological detriment. Patient satisfaction with information was high, with similar levels between groups.
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