Patient satisfaction with nurse-led telephone follow-up after curative treatment for breast cancer

Abstract

Background: Current frequent follow-up after treatment for breast cancer does not meet its intended aims, but does depend on expensive and scarce specialized knowledge for routine history taking and physical examinations. The study described in this paper compared patient satisfaction with a reduced follow-up strategy, i.e. nurse-led telephone follow-up, to satisfaction with traditional hospital follow-up.

Methods: Patient satisfaction was assessed among patients (n=299) who were participants of a randomized controlled trial investigating the cost-effectiveness of several follow-up strategies in the first year after treatment for breast cancer. Data on patient satisfaction were collected at baseline, three, six and 12 months after treatment, using the Dutch version of Ware's Patient Satisfaction Questionnaire III (PSQ III). In addition to general satisfaction, the PSQ III reports on satisfaction scores for technical competence, interpersonal aspects, and access of care. Regression analysis was used to predict satisfaction scores from whether or not nurse-led telephone follow-up was received.

Results: Nurse-led telephone follow-up had no statistically significant influence on general patient satisfaction (p=0.379), satisfaction with technical competence (p=0.249), and satisfaction with interpersonal aspects (p=0.662). Regarding access of care, patient satisfaction scores were significantly higher for patients receiving telephone follow-up (p=0.015). However, a mean difference at 12 months of 3.1 points was judged to be not clinically relevant.

Conclusions: No meaningful differences were found in satisfaction scores between nurse-led telephone and hospital follow-up in the first year after breast cancer treatment. With high satisfaction scores and the potential to substantially reduce clinic visits, nurse-led telephone follow-up may be an acceptable alternative to traditional hospital follow-up.

Trial registration number: ISRCTN 74071417.

Figure 1

Average satisfaction scores for hospital follow-up compared to nurse-led telephone follow-up. Figure 1 presents average satisfaction scores for general satisfaction, access of care, technical competences and interpersonal aspects, at baseline, three, six and 12 months after treatment, for hospital follow-up compared to nurse-led telephone follow-up. Error bars represent 95% confidence intervals.