“The telehealth means I get distance from the hospital so I don’t feel so much like a patient”: A qualitative sub-study examining the acceptability of nurse-led follow-up for ovarian cancer via telehealth using the MOST-S26 to structure consultations.
Authors: Rachel Campbell, Megan Jeon, Michael Friedlander, Madeleine T. King, Andreas Obermair, Sanela Bilic, Alison Brand, Phyllis Butow, Jim Codde, Val Gebski, Jeffrey C. Goh, Angela Ives, Wanda Lawson, Orla McNally, Tarek Meniawy, Linda R. Mileshkin, Rachael L. Morton, Penelope M. Webb, Patsy Yates, Paul Andrew Cohen
Journal: Journal of Clinical Oncology (2025)

12099 Background: The MOST-S26 is a patient-reported outcome measure that complements follow-up after first-line treatment for ovarian cancer (OC). MOST-S26 enables assessment of physical and psychological symptoms, and well-being. A randomized trial was conducted to evaluate nurse-led follow-up for OC via telehealth using the MOST-S26 to structure consultations vs routine hospital follow-up (ACTRN12620000332921). A qualitative sub-study assessed acceptability of the intervention from patient and nurse perspectives. Methods: Semi-structured interviews via video or telephone explored experiences of receiving or delivering nurse-led follow-up. Patients that participated in at least two nurse-led follow-up appointments were eligible. Study nurses delivering the intervention were interviewed at the end of the trial. Interviews were recorded, transcribed and coded using a Framework Approach following five stages: familiarisation, developing a thematic framework, indexing, charting, mapping and interpretation. Results: From June 2021, 38 patients were enrolled at 6 Australian sites. The trial closed to acrual in April 2024. Twenty-one participants were interviewed (15 women with OC and 6 study nurses). Analysis identified 3 overarching themes: (1) key patient-centred benefits (convenience and flexibility; providing a sense of connection and feeling cared for; enabling personalised, holistic care and prompt management of symptoms; providing dedicated space for patients’ to freely express experiences and emotions); (2) challenges to delivery from nurses’ perspectives (emotional impact of patients' cancers recurring; lack of referral pathways; inability to observe physical cues; difficulties establishing rapport; and, lack of suitability for all patients e.g. non-English speaking or patients with low literacy); and, (3) Nurse views on usefulness of MOST-S26 to support consultations (provides a useful tool to guide consultations/referrals, detect recurrence, track symptoms over time, flag symptoms for discussion, and, helps patients’ reflect on their symptoms). Conclusions: Results confirmed acceptability of this type of follow-up for both OC patients and nurses. Both reported several benefits compared with standard hospital-based follow-up. Challenges that should be considered prior to routine implementation of this follow-up model included: the need to provide support to nurses to cope with the emotional impact of patients’ cancers recurring; developing clear referral pathways for symptom management; and considering the characteristics of patients most and least suitable for this type of follow-up. Clinical trial information: ACTRN12620000332921 .