Nurse-led follow-up of patients after oesophageal or gastric cardia cancer surgery: a randomised trial

E.M. Verschuur, E.W. Steyerberg, H.W. Tilanus, S. Polinder, M.L. Essink Bot, K.T. Tran, A. van der Gaast, L.P. Stassen, E.J. Kuipers, P.D. Siersema

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    Abstract

    Between January 2004 and February 2006, 109 patients after intentionally curative surgery for oesophageal or gastric cardia cancer were randomised to standard follow-up of surgeons at the outpatient clinic (standard follow-up; n=55) or by regular home visits of a specialist nurse (nurse-led follow-up; n=54). Longitudinal data on generic (EuroQuol-5D, European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30) and disease-specific quality of life (EORTC QLQ-OES18), patient satisfaction and costs were collected at baseline and at 6 weeks and 4, 7 and 13 months afterwards. We found largely similar quality-of-life scores in the two follow-up groups over time. At 4 and 7 months, slightly more improvement on the EQ-VAS was noted in the nurse-led compared with the standard follow-up group (P=0.13 and 0.12, respectively). Small differences were also found in patient satisfaction between the two groups (P=0.14), with spouses being more satisfied with nurse-led follow-up (P=0.03). No differences were found in most medical outcomes. However, body weight of patients of the standard follow-up group deteriorated slightly (P=0.04), whereas body weight of patients of the nurse-led follow-up group remained stable. Medical costs were lower in the nurse-led follow-up group (2600 euro vs 3800 euro), however, due to the large variation between patients, this was not statistically significant (P=0.11). A cost effectiveness acceptability curve showed that the probability of being cost effective for costs per one point gain in general quality-of-life exceeded 90 and 75% after 4 and 13 months of follow-up, respectively. Nurse-led follow-up at home does not adversely affect quality of life or satisfaction of patients compared with standard follow-up by clinicians at the outpatient clinic. This type of care is very likely to be more cost effective than physician-led follow-up.
    Original languageEnglish
    Pages (from-to)70-6
    JournalBritish Journal of Cancer
    Volume100
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2009

    Cite this

    Verschuur, E. M., Steyerberg, E. W., Tilanus, H. W., Polinder, S., Essink Bot, M. L., Tran, K. T., van der Gaast, A., Stassen, L. P., Kuipers, E. J., & Siersema, P. D. (2009). Nurse-led follow-up of patients after oesophageal or gastric cardia cancer surgery: a randomised trial. British Journal of Cancer, 100(1), 70-6. https://doi.org/10.1038/sj.bjc.6604811