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Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma

BACKGROUND: Patients may decide to undertake shared care with a general practitioner (GP) during follow-up after treatment for localised melanoma. Routine imaging tests for surveillance may be commonly used despite no evidence of clinical utility. This study describes the frequency of shared care an...

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Autores principales: Lim, Wei-Yin, Turner, Robin M., Morton, Rachael L., Jenkins, Marisa C., Irwig, Les, Webster, Angela C., Dieng, Mbathio, Saw, Robyn P. M., Guitera, Pascale, Low, Donald, Low, Cynthia, Bell, Katy J. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6011416/
https://www.ncbi.nlm.nih.gov/pubmed/29925350
http://dx.doi.org/10.1186/s12913-018-3291-7
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author Lim, Wei-Yin
Turner, Robin M.
Morton, Rachael L.
Jenkins, Marisa C.
Irwig, Les
Webster, Angela C.
Dieng, Mbathio
Saw, Robyn P. M.
Guitera, Pascale
Low, Donald
Low, Cynthia
Bell, Katy J. L.
author_facet Lim, Wei-Yin
Turner, Robin M.
Morton, Rachael L.
Jenkins, Marisa C.
Irwig, Les
Webster, Angela C.
Dieng, Mbathio
Saw, Robyn P. M.
Guitera, Pascale
Low, Donald
Low, Cynthia
Bell, Katy J. L.
author_sort Lim, Wei-Yin
collection PubMed
description BACKGROUND: Patients may decide to undertake shared care with a general practitioner (GP) during follow-up after treatment for localised melanoma. Routine imaging tests for surveillance may be commonly used despite no evidence of clinical utility. This study describes the frequency of shared care and routine tests during follow-up after treatment for localised melanoma. METHODS: We randomly sampled 351 people with localised melanoma [American Joint Cancer Committee (AJCC) substages 0 - II] who had not had recurrent or new primary melanoma diagnosed from a total of 902 people diagnosed and treated for localised melanoma at a specialist centre in 2014. We interviewed participants by telephone about their experience of follow-up in the past year, and documented the proportion of patients who were undertaking shared care follow-up with a GP. We also recorded the frequency and type of investigations during follow-up. We calculated weighted estimates that are representative of the full inception cohort. RESULTS: Of the 351 people who were invited to participate, 230 (66%) people consented to the telephone interview. The majority undertook shared care follow-up with a GP (61%). People who choose to have shared care follow-up with a GP are more likely to be male (p = 0.006), have lower AJCC stage (p for trend = 0.02), reside in more remote areas (p for trend< 0.001), and are less likely to have completed secondary school (p < 0.001). Few people saw a non-doctor health practitioner as part of their follow-up (9%). Many people report undergoing tests for melanoma, much of which may be routine tests for surveillance (37%). CONCLUSIONS: The majority of people treated for a first primary localised melanoma at a specialist centre, without recurrent or new melanoma, choose to undertake shared care follow-up with a GP. Many appear to have routine diagnostic imaging as part of their melanoma surveillance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3291-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-60114162018-07-05 Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma Lim, Wei-Yin Turner, Robin M. Morton, Rachael L. Jenkins, Marisa C. Irwig, Les Webster, Angela C. Dieng, Mbathio Saw, Robyn P. M. Guitera, Pascale Low, Donald Low, Cynthia Bell, Katy J. L. BMC Health Serv Res Research Article BACKGROUND: Patients may decide to undertake shared care with a general practitioner (GP) during follow-up after treatment for localised melanoma. Routine imaging tests for surveillance may be commonly used despite no evidence of clinical utility. This study describes the frequency of shared care and routine tests during follow-up after treatment for localised melanoma. METHODS: We randomly sampled 351 people with localised melanoma [American Joint Cancer Committee (AJCC) substages 0 - II] who had not had recurrent or new primary melanoma diagnosed from a total of 902 people diagnosed and treated for localised melanoma at a specialist centre in 2014. We interviewed participants by telephone about their experience of follow-up in the past year, and documented the proportion of patients who were undertaking shared care follow-up with a GP. We also recorded the frequency and type of investigations during follow-up. We calculated weighted estimates that are representative of the full inception cohort. RESULTS: Of the 351 people who were invited to participate, 230 (66%) people consented to the telephone interview. The majority undertook shared care follow-up with a GP (61%). People who choose to have shared care follow-up with a GP are more likely to be male (p = 0.006), have lower AJCC stage (p for trend = 0.02), reside in more remote areas (p for trend< 0.001), and are less likely to have completed secondary school (p < 0.001). Few people saw a non-doctor health practitioner as part of their follow-up (9%). Many people report undergoing tests for melanoma, much of which may be routine tests for surveillance (37%). CONCLUSIONS: The majority of people treated for a first primary localised melanoma at a specialist centre, without recurrent or new melanoma, choose to undertake shared care follow-up with a GP. Many appear to have routine diagnostic imaging as part of their melanoma surveillance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3291-7) contains supplementary material, which is available to authorized users. BioMed Central 2018-06-20 /pmc/articles/PMC6011416/ /pubmed/29925350 http://dx.doi.org/10.1186/s12913-018-3291-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lim, Wei-Yin
Turner, Robin M.
Morton, Rachael L.
Jenkins, Marisa C.
Irwig, Les
Webster, Angela C.
Dieng, Mbathio
Saw, Robyn P. M.
Guitera, Pascale
Low, Donald
Low, Cynthia
Bell, Katy J. L.
Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma
title Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma
title_full Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma
title_fullStr Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma
title_full_unstemmed Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma
title_short Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma
title_sort use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6011416/
https://www.ncbi.nlm.nih.gov/pubmed/29925350
http://dx.doi.org/10.1186/s12913-018-3291-7
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