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BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma

Authors: Wei-Yin Lim, Robin M. Turner, Rachael L. Morton, Marisa C. Jenkins, Les Irwig, Angela C. Webster, Mbathio Dieng, Robyn P. M. Saw, Pascale Guitera, Donald Low, Cynthia Low, Katy J. L. Bell

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

Patients may decide to undertake shared care with a general practitioner (GP) during follow-up after treatment for localised melanoma. Routine imaging tests for surveillance may be commonly used despite no evidence of clinical utility. This study describes the frequency of shared care and routine tests during follow-up after treatment for localised melanoma.

Methods

We randomly sampled 351 people with localised melanoma [American Joint Cancer Committee (AJCC) substages 0 - II] who had not had recurrent or new primary melanoma diagnosed from a total of 902 people diagnosed and treated for localised melanoma at a specialist centre in 2014. We interviewed participants by telephone about their experience of follow-up in the past year, and documented the proportion of patients who were undertaking shared care follow-up with a GP. We also recorded the frequency and type of investigations during follow-up. We calculated weighted estimates that are representative of the full inception cohort.

Results

Of the 351 people who were invited to participate, 230 (66%) people consented to the telephone interview. The majority undertook shared care follow-up with a GP (61%). People who choose to have shared care follow-up with a GP are more likely to be male (p = 0.006), have lower AJCC stage (p for trend = 0.02), reside in more remote areas (p for trend< 0.001), and are less likely to have completed secondary school (p < 0.001). Few people saw a non-doctor health practitioner as part of their follow-up (9%). Many people report undergoing tests for melanoma, much of which may be routine tests for surveillance (37%).

Conclusions

The majority of people treated for a first primary localised melanoma at a specialist centre, without recurrent or new melanoma, choose to undertake shared care follow-up with a GP. Many appear to have routine diagnostic imaging as part of their melanoma surveillance.
Appendix
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Metadata
Title
Use of shared care and routine tests in follow-up after treatment for localised cutaneous melanoma
Authors
Wei-Yin Lim
Robin M. Turner
Rachael L. Morton
Marisa C. Jenkins
Les Irwig
Angela C. Webster
Mbathio Dieng
Robyn P. M. Saw
Pascale Guitera
Donald Low
Cynthia Low
Katy J. L. Bell
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3291-7

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