Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial
Identifieur interne : 002B65 ( Istex/Corpus ); précédent : 002B64; suivant : 002B66Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial
Auteurs : Kinta Beaver ; Debbie Tysver-Robinson ; Malcolm Campbell ; Mary Twomey ; Susan Williamson ; Andrew Hindley ; Shabbir Susnerwala ; Graham Dunn ; Karen LukerSource :
- BMJ [ 0959-8138 ] ; 2009.
Abstract
Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics. Trial registration National Cancer Research Institute 1477.
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DOI: 10.1136/bmj.a3147
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Manchester, Manchester M13 9PL</mods:affiliation></affiliation></author><author><name sortKey="Williamson, Susan" sort="Williamson, Susan" uniqKey="Williamson S" first="Susan" last="Williamson">Susan Williamson</name><affiliation><mods:affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</mods:affiliation></affiliation></author><author><name sortKey="Hindley, Andrew" sort="Hindley, Andrew" uniqKey="Hindley A" first="Andrew" last="Hindley">Andrew Hindley</name><affiliation><mods:affiliation>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</mods:affiliation></affiliation></author><author><name sortKey="Susnerwala, Shabbir" sort="Susnerwala, Shabbir" uniqKey="Susnerwala S" first="Shabbir" last="Susnerwala">Shabbir Susnerwala</name><affiliation><mods:affiliation>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</mods:affiliation></affiliation></author><author><name sortKey="Dunn, Graham" sort="Dunn, Graham" uniqKey="Dunn G" first="Graham" last="Dunn">Graham Dunn</name><affiliation><mods:affiliation>Health Methodology Research Group, University of Manchester, Manchester</mods:affiliation></affiliation></author><author><name sortKey="Luker, Karen" sort="Luker, Karen" uniqKey="Luker K" first="Karen" last="Luker">Karen Luker</name><affiliation><mods:affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2009">2009</date><biblScope unit="volume">338</biblScope></imprint><idno type="ISSN">0959-8138</idno></series><idno type="istex">5D55A63106DF0A493D9213657BB9FBE9C232E231</idno><idno type="DOI">10.1136/bmj.a3147</idno><idno 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Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics. Trial registration National Cancer Research Institute 1477.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>randomised</json:string><json:string>breast cancer</json:string><json:string>recurrence</json:string><json:string>telephone group</json:string><json:string>breast care nurses</json:string><json:string>hospital group</json:string><json:string>online</json:string><json:string>morbidity</json:string><json:string>specialist breast unit</json:string><json:string>moderate risk</json:string><json:string>telephone intervention</json:string><json:string>median</json:string><json:string>participant</json:string><json:string>clinical investigations</json:string><json:string>randomised groups</json:string><json:string>specialist nurses</json:string><json:string>hospital policy</json:string><json:string>time point</json:string><json:string>psychological morbidity</json:string><json:string>anxiety inventory</json:string><json:string>randomised 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telephone</json:string><json:string>interval events</json:string><json:string>overall middle</json:string><json:string>breast care nurse</json:string><json:string>high risk</json:string><json:string>high levels</json:string><json:string>cancer patients</json:string><json:string>early breast cancer</json:string><json:string>small numbers</json:string><json:string>equivalence</json:string></teeft></keywords><author><json:item><name>Kinta Beaver</name><affiliations><json:string>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</json:string><json:string>E-mail: kinta.beaver@manchester.ac.uk</json:string></affiliations></json:item><json:item><name>Debbie Tysver-Robinson</name><affiliations><json:string>Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust, Blackpool, Lancashire</json:string></affiliations></json:item><json:item><name>Malcolm Campbell</name><affiliations><json:string>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</json:string></affiliations></json:item><json:item><name>Mary Twomey</name><affiliations><json:string>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</json:string></affiliations></json:item><json:item><name>Susan Williamson</name><affiliations><json:string>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</json:string></affiliations></json:item><json:item><name>Andrew Hindley</name><affiliations><json:string>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</json:string></affiliations></json:item><json:item><name>Shabbir Susnerwala</name><affiliations><json:string>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</json:string></affiliations></json:item><json:item><name>Graham Dunn</name><affiliations><json:string>Health Methodology Research Group, University of Manchester, Manchester</json:string></affiliations></json:item><json:item><name>Karen Luker</name><affiliations><json:string>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Epidemiologic studies</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Breast cancer</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Screening (oncology)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiology</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Clinical diagnostic tests</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiology (diagnostics)</value></json:item></subject><articleId><json:string>beak584029</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P>0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics. Trial registration National Cancer Research Institute 1477.</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595 x 794 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>2015</abstractCharCount><pdfWordCount>6024</pdfWordCount><pdfCharCount>41460</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>280</abstractWordCount></qualityIndicators><title>Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence 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trial</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>British Medical Journal Publishing Group</publisher><availability status="free"><p>Open Access</p></availability><date>2009-01-14</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial</title><author xml:id="author-1" corresp="yes"><persName><forename type="first">Kinta</forename><surname>Beaver</surname></persName><email>kinta.beaver@manchester.ac.uk</email><note type="biography">professor of nursing</note><affiliation>professor of nursing</affiliation><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation></author><author xml:id="author-2"><persName><forename type="first">Debbie</forename><surname>Tysver-Robinson</surname></persName><note type="biography">nurse consultant</note><affiliation>nurse consultant</affiliation><affiliation>Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust, Blackpool, Lancashire</affiliation></author><author xml:id="author-3"><persName><forename type="first">Malcolm</forename><surname>Campbell</surname></persName><note type="biography">lecturer in statistics</note><affiliation>lecturer in statistics</affiliation><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation></author><author xml:id="author-4"><persName><forename type="first">Mary</forename><surname>Twomey</surname></persName><note type="biography">research associate</note><affiliation>research associate</affiliation><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation></author><author xml:id="author-5"><persName><forename type="first">Susan</forename><surname>Williamson</surname></persName><note type="biography">research fellow</note><affiliation>research fellow</affiliation><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation></author><author xml:id="author-6"><persName><forename type="first">Andrew</forename><surname>Hindley</surname></persName><note type="biography">consultant clinical oncologist</note><affiliation>consultant clinical oncologist</affiliation><affiliation>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</affiliation></author><author xml:id="author-7"><persName><forename type="first">Shabbir</forename><surname>Susnerwala</surname></persName><note type="biography">consultant clinical oncologist</note><affiliation>consultant clinical oncologist</affiliation><affiliation>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</affiliation></author><author xml:id="author-8"><persName><forename type="first">Graham</forename><surname>Dunn</surname></persName><note type="biography">professor of biomedical statistics</note><affiliation>professor of biomedical statistics</affiliation><affiliation>Health Methodology Research Group, University of Manchester, Manchester</affiliation></author><author xml:id="author-9"><persName><forename type="first">Karen</forename><surname>Luker</surname></persName><note type="biography">professor of nursing</note><affiliation>professor of nursing</affiliation><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation></author></analytic><monogr><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="pISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2009"></date><biblScope unit="volume">338</biblScope></imprint></monogr><idno type="istex">5D55A63106DF0A493D9213657BB9FBE9C232E231</idno><idno type="DOI">10.1136/bmj.a3147</idno><idno type="href">bmj-338-bmj-a3147.pdf</idno><idno type="ArticleID">beak584029</idno><idno type="PMID">19147478</idno><idno type="local">bmj;338/jan14_2/a3147</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2009-01-14</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics. Trial registration National Cancer Research Institute 1477.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Epidemiologic studies</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Breast cancer</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Screening (oncology)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Radiology</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Clinical diagnostic tests</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Radiology (diagnostics)</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-01-14">Created</change><change when="2009">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/5D55A63106DF0A493D9213657BB9FBE9C232E231/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">bmj</journal-id><journal-id journal-id-type="nlm-ta">BMJ</journal-id><journal-id journal-id-type="publisher-id">bmj</journal-id><journal-title>BMJ</journal-title><abbrev-journal-title abbrev-type="publisher">BMJ</abbrev-journal-title><issn pub-type="ppub">0959-8138</issn><issn pub-type="epub">1468-5833</issn><publisher><publisher-name>British Medical Journal Publishing Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">beak584029</article-id><article-id pub-id-type="doi">10.1136/bmj.a3147</article-id><article-id pub-id-type="other">bmj;338/jan14_2/a3147</article-id><article-id pub-id-type="other">jan14_2</article-id><article-id pub-id-type="pmid">19147478</article-id><article-id pub-id-type="other">bmj.a3147</article-id><article-id pub-id-type="other">bmj.a3147</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Epidemiologic studies</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Breast cancer</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Screening (oncology)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Radiology</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Clinical diagnostic tests</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Radiology (diagnostics)</subject></subj-group></article-categories><title-group><article-title>Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Beaver</surname><given-names>Kinta</given-names></name><role>professor of nursing</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Tysver-Robinson</surname><given-names>Debbie</given-names></name><role>nurse consultant</role><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Campbell</surname><given-names>Malcolm</given-names></name><role>lecturer in statistics</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Twomey</surname><given-names>Mary</given-names></name><role>research associate</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Williamson</surname><given-names>Susan</given-names></name><role>research fellow</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Hindley</surname><given-names>Andrew</given-names></name><role>consultant clinical oncologist</role><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Susnerwala</surname><given-names>Shabbir</given-names></name><role>consultant clinical oncologist</role><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Dunn</surname><given-names>Graham</given-names></name><role>professor of biomedical statistics</role><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Luker</surname><given-names>Karen</given-names></name><role>professor of nursing</role><xref ref-type="aff" rid="aff1">1</xref></contrib><aff id="aff1"><label>1</label>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</aff><aff id="aff2"><label>2</label>Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust, Blackpool, Lancashire</aff><aff id="aff3"><label>3</label>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</aff><aff id="aff4"><label>4</label>Health Methodology Research Group, University of Manchester, Manchester</aff></contrib-group><author-notes><corresp>Correspondence to: K Beaver <email>kinta.beaver@manchester.ac.uk</email></corresp></author-notes><pub-date pub-type="collection"><year>2009</year></pub-date><pub-date pub-type="ppub"><year>2009</year></pub-date><pub-date pub-type="epub-original"><day>14</day><month>01</month><year>2009</year></pub-date><pub-date pub-type="epub"><day>14</day><month>1</month><year>2009</year></pub-date><volume>338</volume><volume-id pub-id-type="other">338</volume-id><volume-id pub-id-type="other">338</volume-id><elocation-id>a3147</elocation-id><history><date date-type="accepted"><day>15</day><month>October</month><year>2008</year></date></history><permissions><copyright-statement>© Beaver et al 2009</copyright-statement><copyright-year>2009</copyright-year><copyright-holder>Beaver et al</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p></license></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="bmj-338-bmj-a3147.pdf"></self-uri><abstract><p><bold>Objective</bold> To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer.</p><p><bold>Design</bold> A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months.</p><p><bold>Setting</bold> Outpatient clinics in two NHS hospital trusts in the north west of England</p><p><bold>Participants</bold> 374 women treated for breast cancer who were at low to moderate risk of recurrence.</p><p><bold>Interventions</bold> Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy).</p><p><bold>Main outcome measures</bold> Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease.</p><p><bold>Results</bold> The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group <italic>v</italic> 39.0 (10-152) days in telephone group; P=0.228).</p><p><bold>Conclusions</bold> Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics.</p><p><bold>Trial registration</bold> National Cancer Research Institute 1477.</p></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial</title></titleInfo><name type="personal" displayLabel="corresp"><namePart type="given">Kinta</namePart><namePart type="family">Beaver</namePart><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation><affiliation>E-mail: kinta.beaver@manchester.ac.uk</affiliation><description>professor of nursing</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Debbie</namePart><namePart type="family">Tysver-Robinson</namePart><affiliation>Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust, Blackpool, Lancashire</affiliation><description>nurse consultant</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Malcolm</namePart><namePart type="family">Campbell</namePart><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation><description>lecturer in statistics</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mary</namePart><namePart type="family">Twomey</namePart><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation><description>research associate</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Susan</namePart><namePart type="family">Williamson</namePart><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation><description>research fellow</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andrew</namePart><namePart type="family">Hindley</namePart><affiliation>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</affiliation><description>consultant clinical oncologist</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Shabbir</namePart><namePart type="family">Susnerwala</namePart><affiliation>Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</affiliation><description>consultant clinical oncologist</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Graham</namePart><namePart type="family">Dunn</namePart><affiliation>Health Methodology Research Group, University of Manchester, Manchester</affiliation><description>professor of biomedical statistics</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karen</namePart><namePart type="family">Luker</namePart><affiliation>School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</affiliation><description>professor of nursing</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Epidemiologic studies</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Breast cancer</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Screening (oncology)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Radiology</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Clinical diagnostic tests</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Radiology (diagnostics)</topic></subject><originInfo><publisher>British Medical Journal Publishing Group</publisher><dateIssued encoding="w3cdtf">2009</dateIssued><dateCreated encoding="w3cdtf">2009-01-14</dateCreated><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics. Trial registration National Cancer Research Institute 1477.</abstract><relatedItem type="host"><titleInfo><title>BMJ</title></titleInfo><titleInfo type="abbreviated"><title>BMJ</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0959-8138</identifier><identifier type="eISSN">1468-5833</identifier><identifier type="PublisherID">bmj</identifier><identifier type="PublisherID-hwp">bmj</identifier><identifier type="PublisherID-nlm-ta">BMJ</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>338</number></detail></part></relatedItem><identifier type="istex">5D55A63106DF0A493D9213657BB9FBE9C232E231</identifier><identifier type="DOI">10.1136/bmj.a3147</identifier><identifier type="href">bmj-338-bmj-a3147.pdf</identifier><identifier type="ArticleID">beak584029</identifier><identifier type="PMID">19147478</identifier><identifier type="local">bmj;338/jan14_2/a3147</identifier><accessCondition type="use and reproduction" contentType="open-access">This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource><recordOrigin>Beaver et al</recordOrigin></recordInfo></mods></metadata><annexes><json:item><extension>jpeg</extension><original>true</original><mimetype>image/jpeg</mimetype><uri>https://api.istex.fr/document/5D55A63106DF0A493D9213657BB9FBE9C232E231/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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