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.

Findings

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.

Find out more about:

• Shared follow-up care for early breast cancer: Summary of evidence report