Follow-up after treatment for breast cancer: One strategy fits all? An investigation of patient preferences using a discrete choice experiment

Merel L. Kimman, Benedict G. C. Dellaert, Liesbeth J. Boersma, Philippe Lambin, Carmen D. Dirksen
2010 Acta Oncologica  
Clinical guidelines for the follow-up after breast cancer recommend frequent outpatient clinic visits to be examined for a possible recurrence or a second primary breast tumour, and to receive information and psychosocial support. However, needs and preferences for follow-up may differ between patients, raising the question whether the current 'one size fi ts all' approach is appropriate. This study explored patients' preferences for follow-up. Patients and methods. A discrete choice experiment
more » ... survey with 16 choice tasks was fi lled out by 331 breast cancer patients. Each choice task consisted of two hypothetical follow-up scenarios for the fi rst year after treatment, described by levels of the following characteristics; attendance at an educational group programme, frequency of visits, waiting time, contact mode, and type of healthcare provider. Results. The healthcare provider and contact mode were the most important characteristics of follow-up to patients. The medical specialist was the most preferred to perform the follow-up, but a combination of the medical specialist and breast care nurse alternating was also acceptable to patients. Face-to-face contact was strongly preferred to telephone contact. Follow-up visits every three months were preferred over visits every four, six, or 12 months. Heterogeneity in preference between patients was strong, especially for the healthcare provider and attendance at an educational group programme. Age, education, and previous experience with follow-up characteristics infl uenced preferences, but treatment modality did not. Conclusion. The results of this study show that overall patient satisfaction would not differ signifi cantly if patients have follow-up by medical specialist and breast care nurse alternating compared to follow-up by a medical specialist only. Furthermore, we found heterogeneity in preferences for most attributes, indicating that one strategy does not fi t all. Individualised follow-up seems to offer the potential for signifi cant increases in patient satisfaction.
doi:10.3109/02841860903536002 pmid:20148645 fatcat:tkif74q6qvdhlpa77jjenmvvsy