Comparing hospital and telephone follow-up after treatment for breast cancer: Randomised equivalence trial

Objective: To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design: A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting: Outpatient clinics in two NHS hospital trusts in the north west of England Participants: 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions: Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures: Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants' needs for information, participants' satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results: The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (-3.33 to 2.07) was within the predefined equivalence region (-3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P