Comparing hospital and telephone follow-up for patients treated for Stage I endometrial cancer 3 (ENDCAT Trial): a randomised, multicentre, non-inferiority trial

Abstract

Objective
To evaluate the effectiveness of nurse-led telephone follow-up (TFU) for Stage I endometrial cancer patients.

Design
Multicentre, randomised, non-inferiority trial

Setting
Five centres in the North West of England

Sample
259 women treated for Stage I endometrial cancer attending hospital outpatient clinics for routine follow-up

Methods
Participants were randomly allocated to receive traditional hospital based follow-up (HFU) or nurse-led TFU.

Main outcome measures
Primary outcomes were psychological morbidity (State Trait Anxiety Inventory, STAI-S) and patient satisfaction with information. Secondary outcomes included patient satisfaction with service, quality of life, and time to detection of recurrence.

Results
STAI-S scores post-randomisation were similar between groups (mean [SD] TFU 33.0 [11·0], HFU 35.5 [13.0]). The estimated between group difference in STAI was 0·7 (95%CI -1·9 to 3·3); the CI lies above the non-inferiority limit (-3·5) indicating non-inferiority of TFU. There was no significant difference between groups in reported satisfaction with information (OR 0·9, 95% CI 0·4 to 2·1, p=0·83). The HFU group were more likely to report being kept waiting for their appointment (p=0.001), that they did not need any information (p=0.003) and were less likely to report that the nurse knew about their particular case and situation (p=0.005).

Conclusions
TFU provides an effective alternative to HFU for Stage I endometrial cancer patients, with no reported physical or psychological detriment. Patient satisfaction with information was high, with similar levels between groups