Due to an increased cancer survival, more cancer patients are referred to follow-up after primary treatment. Knowledge of patient safety during follow-up is sparse.
Objective: To examine patient-reported errors during cancer follow-up and identify factors associated with errors.
Design: A national survey on cancer patients' experiences of treatment and aftercare was conducted in 2012, about two years following cancer diagnosis (N=6914). Associations between patient-reported errors during follow-up and covariates were examined using multiple logistic regression. Qualitative responses were analysed using text analysis.
Results: This study included 3731 patients, representing a response rate of 64%. Overall, 27.6% of patients reported at least one error during cancer follow-up. 11.7% reported that important information was missing at follow-up consultations; 9.8% were not called in for a follow-up as expected; 16.7% reported that the doctor/nurse handling the follow-up consultation were ill-prepared on their course of disease. Other errors were reported by 4.7%. Patients who reported errors in follow-up were more likely to report an error or complication during primary cancer treatment, not having one health professional with oversight and responsibility for their overall follow-up pathway, be younger, have a diagnosis of rare cancer, poorer self-rated health and high usage of healthcare services.
Conclusion: Workflows related to handling of test results, referrals, bookings and medical records have to be improved. Introduction of one particular healthcare professional responsible for the patients' follow-up may result in fewer patient-reported errors however interventions are needed to examine this. Patients prone to errors should be subject to particular attention.
Keywords: Adverse events; Cancer; Errors; Follow-up; Patient safety; Patient-experiences; Survey.
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