AUTHOR=Newton Claire , Beaver Kinta , Clegg Andrew 

TITLE=Patient initiated follow-up in cancer patients: A systematic review

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.954854

DOI=10.3389/fonc.2022.954854

ISSN=2234-943X

ABSTRACT=Background
Patient-initiated follow-up (PIFU) is increasingly being implemented for oncology patients, particularly during the COVID-19 pandemic, given the necessary reduction in face-to-face hospital outpatient appointments. However, we don’t know if PIFU has a positive (or negative) impact on overall, or progression free, survival. 


Objectives
To investigate the impact of PIFU on overall survival, progression free survival, patient satisfaction, psychological morbidity, QoL and economic costs compared to hospital follow up (HFU) , for any type of cancer.

Methods
We carried out a systematic review using five electronic databases: MEDLINE, CINAHL, EMBASE, PsycInfo and Cochrane Central Register of Controlled Trials. Studies were eligible if they were controlled clinical trials comparing PIFU with another form of active follow-up. Effectiveness was assessed using the primary outcome of overall survival and secondary outcomes of progression free survival, patient satisfaction, psychological morbidity, quality of life and cost effectiveness.

Results 
Eight studies met the inclusion criteria and were included. Only one study included survival as a primary outcome and indicated no significant differences between hospital-based follow-up and PIFU. For secondary outcomes, few differences were found between PIFU and other forms of active follow-up. One study reported significant differences in fear of cancer recurrence between PIFU and HFU; in the short term, fear decreased significantly more in hospital based follow-up.

Conclusion 
We do not have evidence to support the impact of PIFU on survival or progression free survival. Fully powered randomised controlled trials are required to determine the full impact of PIFU in the longer term.