Assessing patient outcomes and cost‐effectiveness of nurse‐led follow‐up for women with breast cancer – have relevant and sensitive evaluation measures been used?
Open accessAbstract
Aims and objectives: To explore how interventions using nurse‐led follow‐up in breast cancer care have been evaluated with a focus on patient outcomes and cost‐effectiveness. Background: As part of the advancement of breast care, nurse‐led follow‐up is increasingly used as an alternative to routine hospital follow‐up in outpatient clinics. There is evidence suggesting that patients appear to be satisfied with the nurse‐led follow‐up, but there is a lack of evidence of whether this perception equates to patients’ satisfaction with the model of physician‐led follow‐up. Design: Systematic review. Method: Three databases were searched, and 29 RCT were initially screened. Finally, 13 articles were critically appraised. Searches included articles between 2005–2013. The quality of appraisal assessment was inspired by the GRADE system. Results: The results show that there are many different instruments used when evaluating nurse‐led follow‐up, which makes it difficult to compare the studies. Several of the studies used QoL as an outcome measure; this is a broad concept that includes several aspects ranging from social role and psychosocial issues to symptoms and therefore difficult to use as an outcome measure. Only two of the studies made any cost‐effective analyses, and the results are hard to interpret. Conclusions: Nurse‐led follow‐up can potentially result in better continuity of care and the availability of more time to provide psychosocial support and address patients’ information needs. However, more well‐conducted research is needed before equivalence to physician‐led follow‐up can be assessed in terms of survival, recurrence, patient well‐being and cost‐effectiveness. Relevance to clinical practice: Results from well‐conducted evaluation studies of nurse‐led services based on theory are needed so that relevant interventions can be implemented in clinical practice. There is a need to in future studies include cost‐effectiveness analyses to compare nurse‐led services with other types of follow‐up.
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Internationally, the concept of the Breast Care Nurse is increasingly being used to identify patients' needs and support delivery of appropriate care.
“Internationally, the concept of the Breast Care Nurse is increasingly being used to identify patients' needs and to support the delivery of appropriate care [18].”
Nurse-led follow-up is reported to potentially support continuity of care, provision of psychosocial support and meeting patients' information needs.
“Nurse-led follow-up is reported to potentially support continuity of care, provision of psychosocial support and meeting patients’ information needs [18].”
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“Internationally, the concept of the Breast Care Nurse is increasingly being used to identify patients’ needs and to support the delivery of appropriate care [18].”
- Authors
- Browall, M., Forsberg, C., & Wengström, Y.
- Affiliations
- University of Skövde (SE)
- Karolinska Institutet (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Browall, Maria
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2017-03-20
- Volume
- 26
- Issue
- 13-14
- Pages
- 1770-1786
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W2492991089
- Cited by
- 37
- References
- 20
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 6 · 2023: 9 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 3 · 2017: 1
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- green
- urn.kb.se
- Licence
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- University Library of Skövde (University of Skövde) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- nurse-led follow-up, breast cancer, patient outcomes, cost-effectiveness, quality of life, outcome measures, continuity of care, psychosocial support, outpatient follow-up, nurse-led services
- MeSH terms
- Ambulatory Care Facilities, Breast Neoplasms, Cost-Benefit Analysis, Female, Follow-Up Studies, Humans, Neoplasm Recurrence, Local, Nursing Process, Patient Satisfaction, Outcome Assessment, Health Care, Practice Patterns, Nurses'
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