Systematic review and meta-analysis of patient reported outcomes for nurse-led models of survivorship care for adult cancer patients

Monterosso, Leanne; Platt, Violet; Bulsara, Max; Berg, Melissa

doi:10.1016/j.ctrv.2018.12.007

Cited by 39 publications

(40 citation statements)

References 54 publications

(312 reference statements)

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“…Global QoL and a number of QoL domains were found to have no significant improvement after nurse‐led interventions over the control group in a meta‐analysis of seven studies, although constipation, insomnia and financial difficulties for patients were improved (Cheng et al., 2018). In a review of survivorship care, the nurse‐led model (4–6 months long) resulted to improved cognitive and social functioning and reduced fatigue (Monterosso et al., 2019). However, QoL as an outcome is also quite a broad concept encompassing multiple domains of life, and this may not be an appropriate primary outcome for trials (Browall et al., 2017).…”

Section: Discussionmentioning

confidence: 99%

Impact of advanced nursing practice through nurse‐led clinics in the care of cancer patients: A scoping review

2020

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Objective This scoping review aims at exploring the effectiveness of nurse‐led advanced practice for patients with cancer. Methods This review followed the PRISMA extension for scoping reviews. Randomised controlled trials on cancer nurse‐led clinics for patient outcomes, costs, service utilisation and other outcomes were included. Databases such as MEDLINE, CENTRAL, CINAHL, EMBASE and PsychINFO were searched based on MeSH terms. Thematic analysis was used to synthesise results of the included studies. Results Seventeen articles were included, published between 2001 and 2019. There were methodological shortcomings with a number of the studies reviewed. Five themes were identified including (1) rationale for developing nurse‐led clinics, (2) mode of delivery of nurse‐led clinics, (3) the content of nurse‐led clinics, (4) exploring patient outcomes and (5) satisfaction with nurse‐led clinics. Conclusions The results support the effectiveness of nurse‐led clinics in improving self‐reported responses such as distress levels, satisfaction, quality of life, depressive symptoms, concerns and vomiting among cancer patients. Following a sound protocol for both the study and the reporting is recommended, and future studies should focus more on costs and effectiveness of different models of care administered by advanced practice nurses. Effectiveness of nurse‐led clinics needs further evaluation with stronger trials and wider focus on nursing‐sensitive clinical outcomes and costs.

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Section: Discussionmentioning

confidence: 99%

Impact of advanced nursing practice through nurse‐led clinics in the care of cancer patients: A scoping review

2020

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“…Mortality rates for cancer are falling globally (Hashim et al, 2016) and it is predicted there will be four million cancer survivors in the UK alone by 2030 (Maddams et al, 2012). Hence, a hospital-based approach to follow-up care is arguably unsustainable from a practical, workforce and financial perspective and there have been recent moves https://doi.org/10.1016/j.ejon.2019.101704 Received 13 August 2019; Received in revised form 8 November 2019; Accepted 26 November 2019 T towards alternative follow-up strategies for different cancer diagnoses, including nurse-led models (Monterosso et al, 2019;Taylor et al, 2019) nurse-led telephone follow-up (Beaver et al, 2009(Beaver et al, , 2012(Beaver et al, , 2017Cox et al, 2008;Kimman et al, 2010;Shaida et al, 2007), General Practitioner (GP) follow-up (Murchie et al, 2010;Grunfeld et al, 1996), technological approaches using, for example, telemedicine, smartphones and computer touchscreen technology to monitor symptoms and concerns (Dickinson et al, 2014;Schougaard et al, 2016;Semple et al, 2018), and patient-initiated follow-up (PIFU) (Kirshbaum et al, 2017;Koinberg et al, 2004). In PIFU, there are no routine scheduled hospital clinic appointments.…”

Section: Introductionmentioning

confidence: 99%

Exploring the acceptability and feasibility of patient-initiated follow-up for women treated for stage I endometrial cancer

Beaver

Martin‐Hirsch

Williamson

et al. 2020

European Journal of Oncology Nursing

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There is a strong shift away from hospital-based approaches to follow-up after active treatment for cancer with supported self-management being promoted as an approach to long term recovery. We aimed to determine the acceptability and feasibility of patient-initiated follow-up (PIFU), supported by a self-management approach, for patients treated for Stage I endometrial cancer. Methods: A mixed methods study was undertaken. Participants were asked to forego hospital outpatient followup appointments, supported by a self-management approach. Outcome measures included satisfaction with information and service, psychological morbidity, quality of life and preferences for follow-up. Qualitative interviews were carried out with study participants to determine their views on follow-up in general and PIFU in particular. Results: We recruited 17 patients. High levels of satisfaction were evident with no physical or psychological detriment. Self-management was a favoured option. Participants questioned the value of hospital follow-up and were willing to engage in self-management if they knew who to contact if they had a problem and were aware of the signs and symptoms of recurrence. However, uptake to the study was low and further work is needed to explore if recruitment to a randomised controlled trial (RCT) is a viable option. Conclusions: Alternative approaches to hospital-based follow-up need to demonstrate that patients feel supported, knowing what symptoms to report and to whom. This study shows acceptability of a supported selfmanagement approach but raises some concerns about the feasibility of recruitment to a future RCT.

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“…The anticipated shortage of the oncology workforce has resulted in greater delegation of complex cancer care to oncology advanced practice nurses (APRNs), who are also experiencing workforce shortages [43]. Robust evidence suggests that improved health outcomes are associated with oncology APRN-led care [44][45][46]. Hence, oncology APRNs are in an optimal position to support cancer survivors' self-management skills building, coordinate care with a PCPs, and use telehealth effectively for post-treatment follow-up.…”

Section: Discussionmentioning

confidence: 99%

Rationale and Design of a Telehealth Self-Management, Shared Care Intervention for Post-treatment Survivors of Lung and Colorectal Cancer

et al. 2021

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Survivors of lung and colorectal cancer have high post-treatment needs; the majority are older and suffer from greater comorbidities and poor quality of life (QOL). They remain underrepresented in research, leading to significant disparities in post-treatment outcomes. Personalized post-treatment follow-up care and care coordination among healthcare teams is a priority for survivors of lung and colorectal cancer. However, there are few evidence-based interventions that address survivors’ post-treatment needs beyond the use of a follow-up care plan. This paper describes the rationale and design of an evidence-informed telehealth intervention that integrates shared care coordination between oncology/primary care and self-management skills building to empower post-treatment survivors of lung and colorectal cancer. The intervention design was informed by (1) contemporary published evidence on cancer survivorship, (2) our previous research in lung and colorectal cancer survivorship, (3) the chronic care self-management model (CCM), and (4) shared post-treatment follow-up care between oncology and primary care. A two-arm, parallel randomized controlled trial will determine the efficacy of the telehealth intervention to improve cancer care delivery and survivor-specific outcomes. ClinicalTrials.govIdentifier: NCT04428905

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Systematic review and meta-analysis of patient reported outcomes for nurse-led models of survivorship care for adult cancer patients

Abstract: Systematic review and metaanalysis of patient reported outcomes for nurse-led models of survivorship care for adult cancer patients.

Cited by 39 publications

References 54 publications

Impact of advanced nursing practice through nurse‐led clinics in the care of cancer patients: A scoping review

Impact of advanced nursing practice through nurse‐led clinics in the care of cancer patients: A scoping review

Exploring the acceptability and feasibility of patient-initiated follow-up for women treated for stage I endometrial cancer

Rationale and Design of a Telehealth Self-Management, Shared Care Intervention for Post-treatment Survivors of Lung and Colorectal Cancer

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