Shared follow-up care for early breast cancer is a safe, effective, acceptable, and cost-efficient alternative to specialist led follow-up care after treatment for early breast cancer.
Building the evidence base
Since 2009, Cancer Australia has undertaken evidence-based research, demonstration and evaluation of shared cancer follow-up and survivorship care for early breast cancer. Key initiatives within Cancer Australia’s program of work include:
- A review of evidence of national and international models of shared follow-up care and current practice across a range of health settings (2009).
- A demonstration project (2009-2011) evaluating health professional and patient acceptability and support for best practice follow-up care.
- An evaluation project (2013-2015) assessing the extent to which the model supported best practice care and qualitatively evaluated patient and GP experiences of shared follow-up care.
- An economic evaluation (2014-15) comparing the cost of shared follow-up care for early breast cancer in a general practice setting to a specialist-led setting.
The aims of the program of work undertaken were to better understand:
- the safety of shared follow-up care in relation to patient outcomes
- the effectiveness of shared follow-up care in delivering patient-centred care
- the acceptability of it to specialists, GPs and patients
- adherence to best practice follow-up care within a shared care model
- the cost-efficiency of shared follow-up care compared with specialist-led models of follow-up care
- the evidence relating to national and international shared follow-up cancer care.
Cancer Australia has found that follow-up care for early breast cancer shared between a specialist and a GP:
- is safe and as effective as specialist-led care in delivering patient-centred care with no differences in survival outcomes, breast cancer recurrences or serious clinical events
- acceptable to patients and health care providers
- supports cancer care being delivered in accordance with evidence-based best practice
- optimises the use of the specialist workforce
- cost efficient for the whole health system compared with specialist-led follow-up care over a lifetime (20, 25 or 30 years). These cost and time savings can be translated to additional and earlier patient care and reduced waiting times for specialist care.