G179(P) Long Term Follow-Up For Paediatric Oncology Patients at a Paediatric Department of a General Hospital

Abstract

Aims Establish how national Long Term Follow Up recommendations can be implemented locally in a paediatric department of a large general hospital. Establish the number of patients who currently have an end of treatment summary in their notes. Determine how many patients are attending appointments. Identify if the appropriate patients are attending clinics. Methods The medical notes for all patients appointed to attend the long term follow up clinic over the preceding two years were reviewed (93 patients). It was noted whether each patient had an end of treatment summary present in their notes Attendance at clinic over the past two years was noted. Patients were assigned into different groups according to the ‘Therapy-based recommended levels of follow-up’.1 Abstract G179(P) Table 1 Level Treatment Follow up Frequency Examples 1 Surgery alone, Low risk Chemotherapy Postal or telephone 1–2 years Low risk Wilms’LCH (single –system)GCH (Surgery only) 2 Chemotherapy, Low dose cranial irradiation (<24 Gy) Nurse-led or primary care 1–2 years Majority of patients (eg ALL) 3 Radiotherapy (> 24 Gy) Megatherapy Medically supervised LFTU Clinic Annually Brain tumours,post BMT, Any stage 4 patients Results The majority (91%) of patients did not have an end of treatment summary in their notes. The majority of patients were in treatment ‘level 2’ (47%).Those in levels 2&3 will require long term medically supervised follow-up (nurse led or GP if level 2). Attendance at clinic was noted & of those attending clinic, those with the best ‘full time’ attendance were those deemed to be ‘level 2’ patients. Followed by level 3 and 1 respectively. Conclusion An ‘End of Treatment Summary’ should be implemented in the notes of all patients who have completed their treatment for childhood cancer. Review current attendance of those deemed to be level 2 or 3 patients with the view to implementing a postal questionnaire in order to re-engage patients currently lost to follow-up. Reference Wallace, W Blacklay, A Eiser, et al. Developing strategies for long term follow up of survivors of childhood cancer. BMJ 2001;323:271-4. Abstract G179(P) Image 1 Abstract G179(P) Image 2 Abstract G179(P) Image 3