Comparison of breast cancer patient satisfaction with follow-up in primarycare versus specialist care: results from a randomized controlled trial

Background. Routine follow-up of breast cancer patients in specialist clini cs is standard practice in most countries. Follow-up involves regularly sch eduled breast cancer check-ups during the disease-free period. The aims of follow-up are to defect breast cancer recurrence and to provide psychosocia l support to the patient; however, little is known about patients' views on breast cancer follow-up. Aim. To assess the effect on patient satisfaction of transferring primary r esponsibility for follow-up of women with breast cancer in remission from h ospital outpatient clinics to general practice. Method. Randomized controlled trial with 18 months' follow-up in which wome n received routine follow-up either in hospital outpatient clinics or from their own general practitioner. Two hundred and ninety-six women with breas t cancer in remission receiving regular follow-up care at two district gene ral hospitals in England were included in the study. Patient satisfaction w as measured by means of a self-administered questionnaire supplied three ti mes during the 18-month study period. Results. The general practice group selected responses indicating greater s atisfaction than did the hospital group on virtually every question. Furthe rmore, in the general practice group there was a significant increase in sa tisfaction over baseline; a similar significant increase in satisfaction ov er baseline was not found in the hospital group. Conclusion. Patients with breast cancer were more satisfied with follow-up in general practice than in hospital outpatient departments. When discussin g follow-up with breast cancer patients, they should be provided with compl ete and accurate information about the goals, expectations, and limitations of the follow-up programme so that they can make an informed choice.