Explorer Follow-up of cancer in primary care versus secondary care : systematic review

Content Provider	Semantic Scholar
Author	Lewis, Ruth A. Neal, Richard David Williams, Nefyn Howard Hendry, Maggie Russell, Daphne Hughes, Clarissa Russell, Ian Stuart, Nicholas S. A. Weller, David Wilkinson, Clare L.
Copyright Year	2017
Abstract	Background Cancer follow-up has traditionally been undertaken in secondary care, but there are increasing calls to deliver it in primary care. Aim To compare the effectiveness and cost-effectiveness of primary versus secondary care follow-up of cancer patients, determine the effectiveness of the integration of primary care in routine hospital follow-up, and evaluate the impact of patient-initiated follow-up on primary care. Design of study Systematic review. Setting Primary and secondary care settings. Method A search was carried out of 19 electronic databases, online trial registries, conference proceedings, and bibliographies of included studies. The review included comparative studies or economic evaluations of primary versus secondary care follow-up, hospital follow-up with formal primary care involvement versus conventional hospital follow-up, and hospital follow-up versus patient-initiated or minimal follow-up if the study reported the impact on primary care. Results There was no statistically significant difference for patient wellbeing, recurrence rate, survival, recurrencerelated serious clinical events, diagnostic delay, or patient satisfaction. GP-led breast cancer follow-up was cheaper than hospital follow-up. Intensified primary health care resulted in increased home-care nurse contact, and improved discharge summary led to increased GP contact. Evaluation of patient-initiated or minimal follow-up found no statistically significant impact on the number of GP consultations or cancerrelated referrals. Conclusion Weak evidence suggests that breast cancer follow-up in primary care is effective. Interventions improving communication between primary and secondary care could lead to greater GP involvement. Discontinuation of formal follow-up may not increase GP workload. However, the quality of the data in general was poor, and no firm conclusions can be reached.
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Alternate Webpage(s)	http://www.research.ed.ac.uk/portal/files/9142700/Follow_up_of_cancer_in_primary_care_versus_secondary_care_systematic_review.pdf
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article