Patient perception of telephone follow-up after resection for colorectal cancer: Is it time for an alternative to the out-patient clinic?

摘要

The economic reality of modern healthcare provides a timely reminder to clinicians of their duty to provide outstanding and cost-effective care. Although multiple guidelines outline investigation, management and surveillance of colorectal cancer, none advocate a particular delivery method. Nurse-led telephone follow-up in multiple specialties has demonstrated equivalent clinical outcomes and patient satisfaction when compared to traditional outpatient department follow-up. This paper aims to compare nurse-led telephone and outpatient follow-up, following surgical resection of colorectal cancer (CRC), focusing on patient perceptions. This cross-sectional study distributed adapted patient satisfaction questionnaire (PS-Q 18) to patients undergoing surveillance following CRC resection via either nurse-led telephone clinics (TC) or standard outpatient department appointments (OPD). 161 questionnaires were distributed (100 OPD, 61 TC); the response rate was 70% for the OPD group, and 87% for the TC group (p=0.02). There was no statistically significant difference between patient reported satisfaction or in preference for healthcare delivery system between groups. More patients in the TC group had serum CEA measured than OPD group. This survey demonstrates high patient satisfaction with telephone follow-up. Owing to the financial benefits on both a patient and healthcare provider level, as well as improved screening uptake (CEA) in our study, a role for this innovative specialist nurse-led telephone clinic clearly exists. The benefits of telephone follow-up in terms of health economics, health equity and adherence to screening protocols support its exclusive role in long-term CRC surveillance.