Structured follow-up of endocrine therapy in breast cancer three months after treatment initiation: a clinical quality improvement project
Ingmarie Olsson, Lina Malmgren, Carina Nexbo, Kristina CaetanoAbstract
Introduction
Women treated with endocrine therapy (ET) after breast cancer often experience side effects that negatively impact quality of life and daily functioning. It is well known that these side effects contribute to many patients discontinuing treatment prematurely, potentially affecting prognosis. Structured support and clear information regarding side effects, self-care, and available interventions are therefore essential. Before the quality improvement project, patients were called by phone approximately three months after starting ET to evaluate side effects, but without a scheduled appointment. This resulted in irregular contact and insufficient preparation on the part of the patients.
Methods
In collaboration between contact nurses, medical secretaries, and the unit manager, work schedules were reorganized to enable scheduled telephone appointments for follow-up of side effects. Procedures were established to ensure that patients receive a booked telephone appointment and complete the Assessment of Rehabilitation Needs Checklist prior to the phone call. A conversation structure was developed to systematically assess side effects, rehabilitation needs, and return to daily life.
Results
All patients prescribed ET are now offered a scheduled telephone appointment. This has enabled more consistent and structured follow-up of the treatment, as well as identification of rehabilitation needs. Individual needs can be identified and person-centered interventions initiated and followed up. The work environment for contact nurses has improved through scheduled calls and continuity is strengthened.
Discussion
Through team collaboration and structural changes, contact nurses stress has been reduced, ET follow-up has improved, and the ability to identify and address rehabilitation needs has increased.