Patient preferences for clinical follow-up after primary treatment for soft tissue sarcoma: a cross-sectional survey and discrete choice experiment

Eur J Surg Oncol. 2014 Dec;40(12):1655-61. doi: 10.1016/j.ejso.2014.04.020. Epub 2014 Jun 26.

Abstract

Background: Patients treated for soft tissue sarcoma (STS) require long-term follow-up to detect recurrent or metastatic disease, yet marked differences exist in clinical approaches to the length of follow-up, frequency of consultations and investigations undertaken at follow-up visits. There has been no published work assessing patient expectations or the acceptability of post-treatment follow-up strategies. This study aimed to assess the patient acceptability of different follow-up strategies following curative surgery for soft tissue sarcoma and to investigate the hypothetical levels of recurrence risk at which different follow-up regimes were acceptable.

Methods: Patients were recruited from the Royal Orthopaedic Hospital in Birmingham. The study used a cross-sectional survey incorporating a best-worst scaling discrete choice experiment to assess patient preferences regarding different aspects of follow-up.

Results: 132 patients participated (47% response). The nature of investigations undertaken during follow-up was the most important aspect of post-surgical care. Patients typically preferred appointments routinely consisting of clinical examination and chest X-ray, and for follow-up to remain in secondary care rather than general practice.

Conclusion: Clear protocols for STS patient follow-up can improve consistency and equity of care. In determining the optimum follow-up plan for STS patients from the patient perspective, this study provides valuable information that should be considered alongside the clinical effectiveness of follow-up strategies to maximise patient outcomes and use NHS resources appropriately.

Keywords: Best-worst scaling; Discrete choice experiment; Follow-up; Secondary care; Soft tissue sarcoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Appointments and Schedules*
  • Choice Behavior*
  • Cross-Sectional Studies
  • England / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Recurrence, Local / prevention & control*
  • Office Visits* / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Preference* / statistics & numerical data
  • Patient Satisfaction
  • Sarcoma / pathology
  • Sarcoma / prevention & control*
  • Sarcoma / therapy
  • Time Factors