Patient-led home-based follow-up after surgery for colorectal cancer: the protocol of the prospective, multicentre FUTURE-primary implementation study

• Published in: BMJ open Vol. 13; no. 10; p. e074089
• Main Authors: Voigt, Kelly Raquel, Wullaert, Lissa, Höppener, Diederik J, Schreinemakers, Jennifer M J, Doornebosch, Pascal G, Verseveld, Maria, Peeters, Koen, Verhoef, Cornelis, Husson, Olga, Grünhagen, Dirk
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 12.10.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Protocol
• Subjects: Antigens; Clinical outcomes; Colorectal cancer; Colorectal surgery; Communication; Cost analysis; Cost control; Health care expenditures; Hospitals; Medical imaging; Metastasis; Patient satisfaction; Patient-Centered Care; Quality of Life; Questionnaires; Surgery; Surveillance
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-074089

IntroductionColorectal cancer (CRC) is the third most common type of cancer in the Netherlands. Approximately 90% of patients can be treated with surgery, which is considered potentially curative. Postoperative surveillance during the first 5 years after surgery pursues to detect metastases in an early, asymptomatic and treatable stage. Multiple large randomised controlled trials have failed to show any (cancer-specific) survival benefit of intensive postoperative surveillance compared with a minimalistic approach in patients with CRC. This raises the question whether an (intensive) in-hospital postoperative surveillance strategy is still warranted from both a patient well-being and societal perspective. A more modern, home-based surveillance strategy could be beneficial in terms of patients’ quality of life and healthcare costs.Methods and analysisThe multicentre, prospective FUTURE-primary study implements a patient-led home-based surveillance after curative CRC treatment. Here, patients are involved in the choice regarding three fundamental aspects of their postoperative surveillance. First regarding frequency, patients can opt for additional follow-up moments to the minimal requirement as outlined by the current Dutch national guidelines. Second regarding the setting, both in-hospital or predominantly home-based options are available. And third, concerning patient–doctor communication choices ranging from in-person to video chat, and even silent check-ups. The aim of the FUTURE-primary study is to evaluate if such a patient-led home-based follow-up approach is successful in terms of quality of life, satisfaction and anxiety compared with historic data. A successful implementation of the patient-led aspect will be assessed by the degree in which the additional, optional follow-up moments are actually utilised. Secondary objectives are to evaluate quality of life, anxiety, fear of cancer recurrence and cost-effectiveness.Ethics and disseminationEthical approval was given by the Medical Ethics Review Committee of Erasmus Medical Centre, The Netherlands (2021-0499). Results will be presented in peer-reviewed journals.Trial registration numberNCT05656326.