Evaluation of local follow-up of long-term cancer survivors – The ADAPT Programme


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Charlotte Summerfield1,Ellie White2,Valerie Goode2,Richard Cowan2,John Radford2
1The University of Manchester,2The Christie NHS Foundation Trust

Abstract

Background

Each year more than 15,800 people in the UK are diagnosed with lymphoma. Despite continually improving outcomes for patients with potentially curable lymphomas, survivors are now threatened by long-term treatment toxicities. Traditional follow-up focuses on detecting disease recurrence, rather than managing co-morbidities. A large tertiary cancer treatment centre in the North West of England implemented the ADAPT programme. ADAPT (Managed local follow-up of long-term lymphoma survivors) aims to transform the location and purpose of follow-up from tertiary to a primary care-based system, developing a more accessible, patient-centred approach. This project will evaluate the long-term health implications of lymphoma treatments using a patient questionnaire and explore the role of patient questionnaires in obtaining annual data of population health.

Method

Of 633 ADAPTed patients, 599 met the criteria to receive the first annual health questionnaire. Descriptive statistics were used to review data from questionnaire responses, in order to determine the prevalence of health problems for lymphoma survivors and their opinions on long-term follow-up.

Results

The study received 296 questionnaire responses, representing a 49% response rate. 98% (n=291) of patients opted to receive future annual health questionnaires. The majority (79%, n=234) of patients had at least 1 health problem. The high prevalence of cardiac disease (25%) amongst the cohort was anticipated. Cardiac complications are known risks of cancer treatment, and, as smoking can further precipitate disease, patients are advised to stop smoking. The study found that 7% (n=21) of patients smoke, highlighting the potential benefits of patient education, with a focus on GP-led smoking cessation.

Conclusion

This quality improvement project supports the use of an annual health questionnaire in the long-term follow-up of lymphoma patients, acknowledging the importance of an efficient, patient-centred approach. Further studies, analysing national patient and clinician compliance with health questionnaires, are required to identify areas for future improvement.