BMJ 1996;313:1547-1548 (14 December)

Letters

More use should be made of specialist nurses

EDITOR,--Eva Grunfeld and colleagues' randomised trial in patients with breast cancer compared community follow up by general practitioners with follow up in a hospital oncology clinic.1 This is an important contribution to our understanding of selected consequences arising from competing surveillance regimens after treatment for operable breast cancer. The rising incidence of breast cancer imposes increasing costs, borne by individuals, the health sector, and society. The end points of the authors' trial were clinical (the time to diagnosis of recurrence and quality of life related to health). These did not differ between the two arms of the trial. The trial did not, however, include any parallel or integrated economic evaluation, which might have identified the more cost effective mode of follow up.

Having a suitably trained clinical nurse specialist to undertake clinical follow up in conjunction with doctors may provide an alternative model. With the increasing trend for patients with . . . [Full text of this article]


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Relevant Article

Routine follow up of breast cancer in primary care: randomised trial
Eva Grunfeld, David Mant, Patricia Yudkin, Ruth Adewuyi-Dalton, David Cole, Jill Stewart, Ray Fitzpatrick, and Martin Vessey
BMJ 1996 313: 665-669. [Abstract] [Full Text]

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