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Group medical consultations in the follow-up of breast cancer: a randomized feasibility study

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Abstract

Purpose

Group medical consultations (GMCs) provide individual medical visits conducted within a group of four to eight peer patients. This study evaluated the feasibility and efficacy of GMCs in the follow-up of breast cancer.

Methods

In this randomized controlled trial, 38 patients participated in a single GMC (intervention group), while the control group (n = 31) received individual outpatient visits. Feasibility is measured in terms of acceptability, demand, practicability and costs, integration and implementation, and efficacy. Between-group differences on the efficacy outcomes distress (SCL-90) and empowerment (CEQ), 1 week and 3 months after the visit, were analyzed using ANCOVAs.

Results

GMCs scored high on most areas of feasibility. Patients in GMCs and individual visits were equally satisfied. Patients and professionals reported more discussed themes in GMCs, despite no between-group differences on information needs prior to the visit. Sixty-nine percent of GMC patients experienced peer support. Costs for GMCs were higher compared to individual visits. However, involving a clinical nurse specialist (CNS) instead of a medical specialist reduced costs to the level of individual CNS care. Efficacy outcomes (distress and empowerment) were equal in both groups.

Conclusion

GMCs in this study were feasible. Further optimization of GMCs in future (cost-)effectiveness trials is possible by increasing the frequency of GMCs, stating criteria for the type of professionals, number of patients involved, and time limits.

Implications for Cancer Survivors

BCS may benefit from GMCs by receiving more information and additional peer support. GMCs cover all aspects of follow-up and may be a good alternative for individual follow-up.

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Acknowledgments

We thank Renate Besselink, clinical nurse specialist, and Linde Bögemann, social worker, for their contribution in many GMCs. We also thank Marianne Deelen, research coordinator, for her efforts in the preparation and logistics of the GMCs.

Conflict of interest

None declared.

Ethical considerations

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Medical Psychology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands

    Annemiek Visser, Paulien H. M. Govaert & Judith B. Prins

  2. Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands

    Hanneke W. M. van Laarhoven

  3. Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Hanneke W. M. van Laarhoven

  4. Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands

    Margrethe S. Schlooz

  5. Department of Surgery, Diakonessenhuis, Utrecht, The Netherlands

    Lisette Jansen & Thijs van Dalen

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  1. Annemiek Visser
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  2. Hanneke W. M. van Laarhoven
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Correspondence to Annemiek Visser.

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Visser, A., van Laarhoven, H.W.M., Govaert, P.H.M. et al. Group medical consultations in the follow-up of breast cancer: a randomized feasibility study. J Cancer Surviv 9, 450–461 (2015). https://doi.org/10.1007/s11764-014-0421-z

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  • DOI: https://doi.org/10.1007/s11764-014-0421-z

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