Background: Many patients report receiving inadequate support for their physical and psychological symptoms during follow-up after first-line treatment for ovarian cancer (OC). MOST-S26 is a patient-reported outcome measure designed to assess physical and psychological symptoms after primary treatment for OC. The MOST follow-up trial (ACTRN12620000332921) evaluated the feasibility of nurse-led follow-up for OC via telehealth using MOST-S26 to structure consultations compared to conventional clinic-based follow-up. This qualitative trial sub-study examined the acceptability of this form of follow-up from patient and nurse perspectives.
Methods: Semi-structured interviews with patients and nurses via video teleconference or telephone. Eligible patients had participated in ≥two nurse-led follow-up appointments. Study nurses who delivered the intervention were interviewed at trial end. Interviews were audio-recorded, transcribed and analysed using a Framework Approach.
Results: 14 patients with OC and 6 study nurses were interviewed. Three overarching themes were identified: (1) key patient-centred benefits (incl. convenience and flexibility; providing a sense of connection and feeling cared for; enabling personalised, holistic care and prompt symptom management; providing space to express emotions); (2) challenges to delivery from nurses’ perspectives (incl. emotional impact on nurses when patients recur; lack of clear referral pathways; inability to observe physical cues; difficulties establishing rapport; and, suitability for all patients e.g. non-English speaking patients); and, (3) Nurse views on usefulness of MOST-S26 to support consultations (incl. MOST-S26 provides a useful tool to guide consultations and referrals, detect early signs of recurrence, track symptoms over time and flag symptoms for discussion).
Conclusions: Results confirmed the acceptability of this form of follow-up for OC from both patient and nurse perspectives. Both reported many benefits of nurse-led follow-up via telehealth using MOST-S26 to structure consultations, relative to standard hospital-based follow-up. However, nurses noted several challenges that need to be considered prior to routine implementation of this form of follow-up.