Increasing numbers of people worldwide are currently living with and beyond cancer and the number is rising. Research shows that many patients have unmet needs following completion of treatment. A hospital based service improvement project, working in partnership with patients and staff, highlighted the need to provide tailored support for patients at the end of treatment. The UK National Cancer Survivorship Initiative recommends patients should receive a personalised care plan and written treatment summary at this time.
The purpose of this project was to improve follow-up support offered to breast cancer patients by implementing a nurse-led End of Treatment Clinic (EoTC). This clinic was set up for breast cancer patients who are 4-6 weeks post chemotherapy treatment. The clinic is run by specialist nurses who undertake a holistic needs assessment, provide patients with a written treatment summary and care plan and refer to relevant survivorship services. We simultaneously evaluated the efficacy, acceptability and demand for the clinic by surveying attendees and auditing EoTC documentation. In addition 13 qualitative interviews were conducted with recipients of the EoTC which explored the benefits of EoTC and opinions regarding management and care plans. All interviews were audio recorded, transcribed and analysed using thematic analysis.
Patients were very positive about holistic needs assessment, whilst also praising the individualised assessments they received. Rapport with nurses and reassurance as a result of the consultation were greatly valued. Concerns post treatment included fear of recurrence and body image. Continuity of care was appreciated.
Participants reported how EoTC met their need for information, support, reassurance and navigation of the health care system. The EoTC was perceived as acceptable, with patients reporting satisfaction with their care. The management and care plan was valuable for achieving future health related goals. The consultations also improved patient in better understanding of cancer treatments.