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274 A prospective study of telephonic contact and subsequent physical follow-up of radically treated lung cancer patients

In International Journal of Radiation Oncology, Biology, Physics
By: Mathew AS.
Contributor(s): Laskar SG | Munshi A | Agarwal JP.
Material type: materialTypeLabelArticleSeries: Issues: 3 Suppl 1 Vol. 93. Publisher: 2015Description: s120.Subject(s): Radical treatment | Lung cancer In: International Journal of Radiation Oncology, Biology, PhysicsSummary: Purpose/Objective(s) There are limited and contradictory data available regarding the benefit of follow-up visits in lung cancer patients treated with curative intent. We wanted to test the hypothesis that telephonic follow-up may offer a convenient and equivalent alternative to physical follow-up of such patients. Materials/Methods Two hundred consecutive lung cancer patients treated with curative intent were interviewed telephonically, before their scheduled hospital visit, and in person at the hospital visit with the help of a questionnaire to generate a telephonic impression and a corresponding physical impression of disease status. The patients satisfaction with the telephonic call and the physical visit, the anxiety level of patient after meeting the physician and the economic burden of the visit to the patient were noted in a descriptive manner. Kappa statistics was used to assess concurrence. This study was funded by an intra-mural grant from our institution. Results With a median telephonic follow up of 21.5 months, the Kappa score for concurrence between telephonic impression and the physical impression of disease status for the entire cohort of patients was 0.46, with a prevalence and bias adjusted Kappa (PABAK) Score of 0.64 (95% CI = 0.580.70) indicating substantial agreement. When data was analyzed up to first disease progression/relapse on follow-up, PABAK score was 0.71 (95% CI = 0.640.77) for all followups together indicating substantial agreement. Patients whose disease was controlled at the respective follow-up had a further more significant PABAK score of 0.88 (95% CI = 0.800.94) indicating excellent concurrence. On average, each patient spent INR 5117.10 on travel and INR 3079.06 on lodging (approximately $82 and $50 respectively) per follow-up visit. The median satisfaction score for telephonic follow up was 8, while the median score for physical follow-up was 9. Conclusion At present, the importance of physical follow-up to a patient is high; however, this study shows that telephonic follow-up is substantially accurate in assessing disease status until first relapse. In a resource-constrained country like India, it is worthwhile to further explore the benefits of such an alternative strategy, especially in view of the potential savings of money and time both to the patient and health facility. These can be better understood in a randomized trial.
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Purpose/Objective(s) There are limited and contradictory data available regarding the benefit of follow-up visits in lung cancer patients treated with curative intent. We wanted to test the hypothesis that telephonic follow-up may offer a convenient and equivalent alternative to physical follow-up of such patients. Materials/Methods Two hundred consecutive lung cancer patients treated with curative intent were interviewed telephonically, before their scheduled hospital visit, and in person at the hospital visit with the help of a questionnaire to generate a telephonic impression and a corresponding physical impression of disease status. The patients satisfaction with the telephonic call and the physical visit, the anxiety level of patient after meeting the physician and the economic burden of the visit to the patient were noted in a descriptive manner. Kappa statistics was used to assess concurrence. This study was funded by an intra-mural grant from our institution. Results With a median telephonic follow up of 21.5 months, the Kappa score for concurrence between telephonic impression and the physical impression of disease status for the entire cohort of patients was 0.46, with a prevalence and bias adjusted Kappa (PABAK) Score of 0.64 (95% CI = 0.580.70) indicating substantial agreement. When data was analyzed up to first disease progression/relapse on follow-up, PABAK score was 0.71 (95% CI = 0.640.77) for all followups together indicating substantial agreement. Patients whose disease was controlled at the respective follow-up had a further more significant PABAK score of 0.88 (95% CI = 0.800.94) indicating excellent concurrence. On average, each patient spent INR 5117.10 on travel and INR 3079.06 on lodging (approximately $82 and $50 respectively) per follow-up visit. The median satisfaction score for telephonic follow up was 8, while the median score for physical follow-up was 9. Conclusion At present, the importance of physical follow-up to a patient is high; however, this study shows that telephonic follow-up is substantially accurate in assessing disease status until first relapse. In a resource-constrained country like India, it is worthwhile to further explore the benefits of such an alternative strategy, especially in view of the potential savings of money and time both to the patient and health facility. These can be better understood in a randomized trial.

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