Personalised FollowUp for patients with head and neck cancer: quality of life and patient experience
Laura Dean,
United Kingdom
PO-1067
Abstract
Personalised FollowUp for patients with head and neck cancer: quality of life and patient experience
Authors: Laura Dean1, Dr. Teresa Guererro-Urbano1, Dr. Catherine Oakley2, Dr. Mary Lei1
1Guy's and St. Thomas' NHS Foundation Trust, Clinical Oncology, Head and Neck, London, United Kingdom; 2Guy's and St. Thomas' NHS Foundation Trust, Chemotherapy Nurse Consultant, London, United Kingdom
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Purpose or Objective
In 2019, NHS England set the ambition to deliver Personalised stratified Follow-up (PFU) to patients following treatment for cancer. A novel PFU programme for patients who have been treated for Head and Neck Cancer (HNC) was implemented in 2021. Suitable patients are discharged by oncologists at their 2 year follow-up review onto a PFU pathway. Patients are invited to a nurse-led PFU clinic where they receive personalised assessment and education. We wished to evaluate quality of life (QOL) and health needs of patients in PFU and to understand patient experience of the PFU clinic.
Material and Methods
Institutional approval was obtained for the implementation of the PFU programme. 25 patients were identified between May and September 2022 using pre-agreed criteria and consented to transfer to a PFU pathway. Prior to the PFU clinic, patients were invited to complete a European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck (EORTC QLQ HN43) Patient Reported Outcome Measure (PROM) and a Holistic Needs Assessment (HNA) questionnaire. In the PROM data patients reported concerns using a 4 point Likert scale to indicate impact on QOL. Scores were then converted to a 0-100 scale, with scores above 60 identified as of Significant Concern (SC). HNA data was collected on the electronic platform hosted by Macmillan. Patients scored concerns using the ‘Distress Scale’ of 0-10. PROM and HNA data were reviewed with patients with co-development of a Personalised Care Plan and Treatment Summary. Patients were offered a post-clinic survey 1 week later.
Results
80% (n=19) of PFU patients returned PROM data. 5 patients identified 1 SC and 1 identified 2 SCs. All SC concerns raised were identified as common long term side effects of the treatment.
92% (n=23) patients returned HNA data. 30% (n=7) of patients identified concerns that impacted QOL. No patients identified a concern that scored greater than 6. The average concern score was 4.3. The most common concern raised throughout PROMS and HNA data was a ‘Dry Mouth.’
Questionnaire Concern Subtype
| HNA | PROM |
Physical
| 67% (n= 8)
| 85% (n=6)
|
Emotional
| 16% (n=2)
| 15% (n=1)
|
The post clinic survey suggested 100% (n=22) of patients continued to feel supported despite being discharged from routine oncology follow-up. 86% of patients felt at the centre of the decision making process. 82% of patients were aware of how to access health and wellbeing (HWB) support. 13% (n=3) stated they would like to attend HWB events that focused on improving QOL after treatment for cancer.
Conclusion
Whilst a small number of patients reported significant health concerns, the majority did not feel they required further support with these. The PFU clinic provides the opportunity to focus on patient needs at the point of discharge from routine oncology care. Patients felt supported by their team whilst being empowered to take control of the way their care is provided. Evidence so far supports the ongoing PFU programme for patients with HNC.