Group medical consultations (GMCs) and tablet-based online support group sessions in the follow-up of breast cancer: A multicenter randomized controlled trial.

OBJECTIVE: Group medical consultations (GMCs) provide individual medical visits in the presence of ≤7 peer-patients. In the follow-up of breast cancer, we evaluated the efficacy of a new type of blended care My-GMC, a GMC combined with a tablet-based online app, consisting of three online support group sessions (SGS) and additional information. METHODS: This randomized controlled trial compared the effect of My-GMC (n = 59) with one individual medical visit (n = 50) (care as usual). Between-group differences on the outcomes distress and empowerment were analyzed 1 week, 3 and 6 months after the visit. RESULTS: No between-group differences were found for the primary outcomes distress and empowerment. More themes were discussed in GMCs compared to individual visits. Significantly more patients experienced peer-support in GMCs (78%) than via the online app (29%). Satisfaction with the online app was low. CONCLUSIONS: My-GMC did not result in improvements in distress or empowerment, which might partly be explained by low baseline distress levels. This paper provides valuable information concerning factors on organizational level as well as individual level influencing the evaluation of a blended care intervention. PRACTICE IMPLICATIONS: My-GMC provided an innovative alternative, combining professional and peer-support in face-to-face and online SGS, resulting in additional information provision and peer-support. Further improvement of the apps is needed to improve user satisfaction. NETHERLANDS TRIAL REGISTER: NTR3771.

Group medical consultations in the follow-up of breast cancer: a randomized feasibility study.

PURPOSE: Group medical consultations (GMCs) provide individual medical visits conducted within a group of four to eight peer patients. This study evaluated the feasibility and efficacy of GMCs in the follow-up of breast cancer. METHODS: In this randomized controlled trial, 38 patients participated in a single GMC (intervention group), while the control group (n = 31) received individual outpatient visits. Feasibility is measured in terms of acceptability, demand, practicability and costs, integration and implementation, and efficacy. Between-group differences on the efficacy outcomes distress (SCL-90) and empowerment (CEQ), 1 week and 3 months after the visit, were analyzed using ANCOVAs. RESULTS: GMCs scored high on most areas of feasibility. Patients in GMCs and individual visits were equally satisfied. Patients and professionals reported more discussed themes in GMCs, despite no between-group differences on information needs prior to the visit. Sixty-nine percent of GMC patients experienced peer support. Costs for GMCs were higher compared to individual visits. However, involving a clinical nurse specialist (CNS) instead of a medical specialist reduced costs to the level of individual CNS care. Efficacy outcomes (distress and empowerment) were equal in both groups. CONCLUSION: GMCs in this study were feasible. Further optimization of GMCs in future (cost-)effectiveness trials is possible by increasing the frequency of GMCs, stating criteria for the type of professionals, number of patients involved, and time limits. IMPLICATIONS FOR CANCER SURVIVORS: BCS may benefit from GMCs by receiving more information and additional peer support. GMCs cover all aspects of follow-up and may be a good alternative for individual follow-up.