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Randomized Controlled Trial
. 2020 Nov;29(6):e13325.
doi: 10.1111/ecc.13325. Epub 2020 Sep 5.

Nurse-led follow-up in survivorship care of gynaecological malignancies-A randomised controlled trial

Siew-Fei Ngu  1 , Na Wei  1 , Justin Li  2 , Mandy M Y Chu  1 , Ka Yu Tse  1 , Hextan Y S Ngan  1 , Karen K L Chan  1
Affiliations
Randomized Controlled Trial

Nurse-led follow-up in survivorship care of gynaecological malignancies-A randomised controlled trial

Siew-Fei Ngu et al. Eur J Cancer Care (Engl). 2020 Nov.

Abstract

Objective: To assess clinical and psychosocial outcomes of nurse-led follow-up in survivorship care of gynaecological malignancies.

Methods: Women with endometrial or ovarian cancer who were attending regular post-treatment follow-up at a tertiary referral centre were randomised into two groups-group-1: telephone follow-up by nurses and group-2: gynaecologists-led clinic follow-up. Women in group-1 were asked about their symptoms and quality of life (QoL) by nurses. Women in group-2 were followed up by gynaecologists and underwent symptom reviews and physical examinations. All ovarian cancer patients in both groups also had CA125 measured. All recruited women completed a QoL questionnaire (EORTC QLQ-C30), HADS-anxiety questionnaire and symptom checklist.

Results: 385 women (215 with endometrial and 170 with ovarian cancer) were randomised. There was no significant difference in the detection of recurrence according to the two follow-up protocols. However, women in the nurse-led arm scored higher on emotional (p = 0.023) and cognitive functioning (p = 0.012). Those in the gynaecologist-led arm scored higher on the HADS-anxiety scale (p = 0.001) and were more likely to report symptoms.

Conclusions: Our results demonstrate a preliminary non-inferiority of nurse-led follow-up, with improved psychological morbidity and QoL. Thus, nurse-led follow-up can be considered an effective substitute for hospital-based care.

Keywords: endometrial cancer; follow-up; gynaecological cancer; ovarian cancer; quality of life; survivorship.

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References

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