Grunfeld et al, 1996.3 Cancer site: breast. Length of follow-up: median 18 months. | Mean change from baseline for HADS score; difference in means (95% CI): | Mean change from baseline for SF-36 score; difference in mean change from baseline (95% CI): | Number of patients who ‘agreed’ or ‘sometimes agreed’ vs ‘can't say’ ‘disagree’ and the difference between groups (95% CI): (at 9 months only): |
Sample size: n = 296; GP n = 148, H n = 148. | Anxiety | GP 0.3 vs H 0.1; 0.4 (0.3 to 1.2) | Physical functioning | GP −1.6 vs H −4.7; 3.1 (−1.1 to 7.5) | Service delivery | |
Questionnaire response rates after denominators adjusted for those who died or gone away (n = 2): GP 137/141 (97%), H 119/135 (88%) | Depression | GP 0.6 vs H 0.2; 0.4 (0.2 to 1.1) | Pain | GP –0.6 vs H –4.4; 3.8 (–1.5 to 9.2) | If urgent you can see Dr | GP 116/138 vs H 61/120; 33.2 (22.4 to 44.1) |
| | | Social | GP −4.8 vs H −3.0; −1.8 (−7.2 to 3.5) | Usually seen by Dr within 20 minutes | GP 134/138 vs H 111/122; 6.1 (0.3 to 11.9) |
| | | Role functioning — physical | GP 5.2 vs H 1.0; 4.1 (−5.6 to 13.9) | Not enough time to discuss problems with Dr | GP 38/136 vs H 56/119; −19.1 (−30.8 to −7.4) |
| | | Role functioning — emotional | GP 1.9 vs H 0.1; 1.8 (−7.3 to 10.8) | The consultation | |
| | | General health perception | GP −2.0 vs H −2.6; 0.6 (−3.6 to 4.8) | Get good advice on how to keep healthy | GP 112/138 vs H 77/121; 17.5 (6.8 to 28.3) |
| | | Mental health | GP −1.6 vs H −2.1; 0.5 (−4.1 to 5.1) | Sometimes difficult to discuss concerns with the Dr | GP 39/136 vs H 48/121; −11.0 (−22.6 to 0.57) |
| | | Vitality | GP 1.3 vs H −2.5; 3.8 (−0.7 to 8.3) | | |
| | | Mean change from baseline for EORTC symptom scale score; difference in mean change from baseline (95% CI): | Dr explains clearly what is wrong | GP 126/138 vs H 103/120; 5.5 (−2.3 to 13.3) |
| | | Fatigue | GP 1.5 vs H 3.7;–2.2 (−6.5 to 2.2) | | |
| | | Pain | GP 0.1 vs H 2.7; −2.6 (−8.0 to 2.8) | Dr examines you thoroughly when necessary | GP 136/138 vs H 119/121; 0.2 (−2.8 to 3.2) |
| | | Dyspnoea | GP 3.0 vs H 7.6; −4.6 (−9.8 to 0.6) | | |
| | | Sleep disturbances | GP −1.7 vs H 2.0; −3.7 (−10.4 to 2.9) | Sometimes think Dr should listen more to what you say | GP 38/136 vs H 52/119; −17.2 (−28.8 to −5.6) |
| | | Appetite loss | GP 1.4 vs H 4.1; −2.7 (−7.4 to 2.3) | Dr should tell you more about problem and treatment | GP 63/135 vs H 76/119; −17.2 (−29.3 to −5.1) |
| | | | | Dr encourages you to talk about problem and treatment | GP 126/137 vs H 91/120; 16.1 (7.2 to 25.0) |
| | | | | See a Dr that knows you well | GP 124/138 vs H 65/121; 36.1 (25.9 to 46.3) |
| | | | | Have to wait too long for an appointment with Dr you want | GP 54/136 vs H 31/118; 13.41 (2.0 to 24.9) |
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Grunfeld et al, 2006.27 Cancer site: breast. Length of follow-up: median 3.5 years. Sample size: n = 968; GP n = 483, H n = 485. Questionnaire response (at 60 months) after denominators adjusted for those who died: GP 106/480 (22%), H 104/483 (22%) | Using a growth model, there were no statistically significant differences (P<0.05, likelihood ratio test) between the groups over time for mean HADS scores. (Mean response profiles were presented but no raw data given. HADS measured during interval the patient was recurrence free) | Using a growth model, there were no statistically significant differences (P<0.05, likelihood ratio test) between the groups over time for mean SF-36 physical or mental component scores. (Mean response profiles were presented but no raw data given. SF-36 measured during interval the patient was recurrence free) | — | |
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Wattchow et al, 2006.30 Cancer site: colon. Length of follow-up: 24 months. Sample size: n = 203; GP n = 97, H n = 106. Questionnaire response after denominators adjusted for those who died: GP 76/89 (85%), hospital 79/95 (83%) | Median (interquartile range) HADS score; P adjusted analysis for baseline differences: | Median (interquartile range) SF-12 score; P adjusted analysis for baseline differences: | % of patients rating ‘excellent’ or 'very good; GP n = 76 vs surgeon n = 81: |
| Anxiety | GP 4.0 (5.0) vs H 5.0 (4.5); P = 0.11a | Physical component | GP 48.5 (17.7) vs H 50.4 (14.4); P = 0.28a | Wait for an appointment | GP 82 vs H 82, P = 0.69b |
| Depression | GP 4.0 (5.0) vs H 3.0 (4.0); P = 0.80a | Mental component | GP 54.4 (17.7) vs H 55.9 (14.4); P = 0.47a | Convenience of location | GP 84 vs H 78, P = 0.18b |
| | | | | Reaching Dr by phone | GP 69 vs H 62, P = 0.26b |
| | | | | Time in waiting room | GP 56 vs H 59, P = 1.00b |
| | | | | Average time with Dr | GP 77 vs H 69, P = 0.12b |
| | | | | Explanation given | GP 84 vs H 81, P = 0.33b |
| | | | | Technical skills of Dr | GP 89 vs H 90, P = 0.50b |
| | | | | Personal manner of Dr | GP 97 vs H 95, P = 0.08b |
| | | | | Overall satisfaction with Dr | GP 96 vs H 92, P = 0.06b |
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Holtedahl et al, 2005.31 Cancer site: multiple sites. Length of follow-up: 6 months. Sample size: Int n = 41, H n = 50. Questionnaire response rate was Int: 88%, H: 90% | — | Mean change from baseline for EORTC QLQ-C30; estimate for differences between groups (95% CI): | — | |
| | | Functional scales | | |
| | | Physical | Int 2.6 vs H 4.0; −1.4 (−7.62 to 4.82) | | |
| | | Role | Int 3.3 vs H 12.6; −9.3 (−20.41 to 1.81) | | |
| | | Cognitive | Int 3.2 vs H 1.8; 1.40 (−8.04 to 10.84) | | |
| | | Emotional | Int 2.4 vs H 4.3; −1.90 (−9.52 to 5.72) | | |
| | | Social | Int 0.0 vs H 11.4; −11.40 (−22.90 to 0.10) | | |
| | | Global QoL | Int 2.3 vs H 2.3; 0.00 (−7.16 to 7.16) | | |
| | | Symptom scales/items | | |
| | | Fatigue | Int −1.9 vs H −4.9; 3.00 (−7.21 to 13.21) | | |
| | | Nausea/vomiting | Int 0.0 vs H −2.6; 2.60 (−5.07 to 10.27) | | |
| | | Pain | Int −7.4 vs H −4.0; −3.40 (−14.32 to 7.52) | | |
| | | Dyspnoea | Int 8.3 vs H 0.7; 7.60 (−4.45 to 19.65) | | |
| | | Sleep disturbances | Int 0.9 vs H −7.4; 8.30 (−4.52 to 21.12) | | |
| | | Appetite loss | Int 1.9 vs H −2.9; 4.80 (−4.58 to 14.18) | | |
| | | Constipation | Int 0.9 vs H −0.8; 1.70 (−10.02 to 13.42) | | |
| | | Diarrhoea | Int −4.6 vs H 3.0; −7.60 (−19.76 to 4.56) | | |
| | | Financial impact | Int 2.8 vs H −0.8; 3.60 (−4.64 to 11.84) | | |
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Nielsen et al, 2003.33 Cancer site: multiple sites. Length of follow-up: 6 months since diagnosis. Sample size: Int n = 121, H n = 127. Questionnaire response rate was Int: 78%, H: 64% | — | | Mean EORTC QLQ-C30 scores: | Mean patients' attitudes (high score = more positive attitude): |
| | | Functional scales | Intersectoral cooperation | Int 59.22 vs H 51.71 (n = 62); P = 0.055c |
| | | Physical | Int 80.92 vs H 81.32; P = 0.621c | Global assessment of intersectoral cooperation | Int 63.73 (n = 71) vs H 58.55 (n = 76); P = 0.142c |
| | | Role | Int 73.42 vs H 72.71; P = 0.781c | | |
| | | Cognitive | Int 81.88 vs H 84.98; P = 0.357c | Feeling of not being left in limbo | Int 65.49 (n = 65) vs H 58.55 (n = 77); P = 0.055c |
| | | Emotional | Int 75.42 vs H 78.14; P = 0.665c | | |
| | | Social | Int 84.17 vs H 83.70; P = 0.744c | Global assessment of the feeling of not being left in limbo | Int 57.64 (n = 72) vs H 52.71 (n = 83); P = 0.324c |
| | | Global QoL | Int 69.79 vs H 69.11; P = 0.933c | | |
| | | Symptom scales/items | | |
| | | Fatigue | Int 29.31 vs H 31.14; P = 0.874c | Information from GP | Int 74.27 (n = 43) vs H 68.59 (n = 38); P = 0.377c |
| | | Nausea/vomiting | Int 8.13 vs H 8.15; P = 0.843c | Care from the GP | Int 79.22 (n = 45) vs H 77.50 (n = 36); P = 0.542c |
| | | | | GPs' knowledge | Int 64.84 (n = 32) vs H 66.67 (n = 27); P = 0.588c |
| | | Pain | Int 19.38 vs H 21.80; P = 0.345c | Global assessment of the GP | Int 68.89 (n = 45) vs H 64.02 (n = 41); P = 0.438c |
| | | Dyspnoea | Int 15.00 vs H 14.49; P = 0.921c | | |
| | | Insomnia | Int 22.50 vs H 24.28; P = 0.729c | | |
| | | Appetite loss | Int 15.00 vs H 15.22; P = 0.591c | | |
| | | Constipation | Int 12.50 vs H 10.26; P = 0.502c | | |
| | | Diarrhoea | Int 11.25 vs H 13.55; P = 0.564c | | |
| | | Financial impact | Int 11.39 vs H 16.85; P = 0.110c | | |