Title: Comparing hospital and telephone follow-up for women treated for endometrial cancer (ENDCAT: Endometrial Cancer Telephone follow-up trial)
Funder: Department of Health (England)

Abstract: Background Over 7,200 British women are diagnosed a year with endometrial cancer (1). Following treatment, patients attend regular outpatient appointments. However, evidence suggests that routine clinical review has little benefit in terms of survival or detection of recurrent disease (2). Hospital consultations are reassuring for patients but do not always provide the information people need to live well following diagnosis and treatment (3). The National Cancer Survivorship Initiative calls for new models of after care to be evaluated (4). We harness the skills and expertise of specialist nurses to meet the information needs of women treated for endometrial cancer, testing an alternative strategy that aims to provide a quality service to patients while relieving pressure on busy hospital clinics. Aims This study aims to demonstrate that specialist nurses have the skills and expertise to meet the information needs and concerns of women treated for endometrial cancer, with no physical or psychological detriment, by carrying out a randomised controlled trial comparing traditional hospital follow-up with telephone follow-up by specialist gynaecology oncology nurses. In addition, we aim to explore patient views and experiences of receiving telephone follow-up. Plan of Investigation This study is a randomised controlled trial (RCT) comparing two forms of service provision: standard hospital outpatient follow-up (control arm) and a telephone intervention administered by specialist gynaecology oncology nurses (intervention arm). Primary outcomes are psychological morbidity and patient satisfaction with information; secondary outcomes are quality of life, patient satisfaction with service, number of referrals, time to detection of recurrent disease and cost effectiveness (efficiency). In addition we will also conduct a qualitative study, using semi-structured interviews, to obtain more in-depth information on patients’ experiences of telephone follow-up and nurse specialist views on positive and negative aspects of delivering the telephone intervention. Potential Impact The impact of this study is centred on providing real patient benefit by ensuring patients have the information they need to live well after treatment for cancer within current resource limitations. We aim to provide a high quality service to women treated for endometrial cancer, being responsive to Department of Health initiatives calling for new models of care to empower patients with cancer to manage their condition (4). In 2008-2009 there were over 80,000 gynaecology oncology hospital appointments in England, compared to 10,000 in 2005-2006 (5). If this trend continues it is unlikely that outpatient departments will be able to balance limited resources against demand for services. This study is intended to reduce the burden on NHS hospital clinics without detriment to patient care.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: CANCER AND NEOPLASMS