Background The current economic climate, increasing cancer survivorship, frailty and palliative care needs has led to a focus on resources. One method being evaluated is patient-led follow-up (PLFU) as a safe, more cost-effective alternative to traditional follow-up. Evidence shows that traditional appointments do not necessarily coincide with patient need or symptoms, and the volume of reviews limits the ability to respond to more urgent needs. Studies in rheumatology and breast cancer patients have demonstrated that nurse-led telephone helplines, education sessions, and open-access in ‘low-risk’ groups resulted in significant reductions in healthcare utilisation without compromising clinical or psychological wellbeing. Furthermore, qualitative evidence suggests PLFU patients felt empowered. Within palliative medicine, focus has shifted towards Phase of Illness to determine follow-up frequency, with stable patients being moved towards PLFU.
Methods A cross sectional cohort of PLFU patients is being followed for six months. Data being collected includes Phase, Karnofsky Performance Score (KPS), diagnosis, Integrated Palliative care Outcome Scale (IPOS) and outcome.
Results The project is ongoing but preliminary findings include identifying two cohorts frequently assigned to PLFU; nursing home patients, and breast cancer patients. Breast follow-up appears to be leading the way in PLFU, therefore patients transitioning from oncology follow-up to palliative care may be more amenable to a PLFU approach.
Conclusions The literature has demonstrated PLFU as a safe, cost-effective alternative to traditional follow-up and a way of ensuring a reactive service with resources to respond to crises whilst encouraging self-management and patient empowerment. Our study aims to demonstrate how PLFU translates to palliative care, and how we might identify those patients who would be candidates for this approach. It also aims to gain qualitative feedback from focus groups of both patients and relatives of deceased patients who can reflect on the transition to PLFU.
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