Localized versus centralized nurse-delivered telephone services for people in follow up for cancer: opinions of cancer clinicians

Aim: Telephone-delivered supportive care interventions hold potential as a sustainable, low-resource option to improve patients' outcomes. Such interventions may be delivered centrally or locally. There is limited information about clinicians' preferences for these alternative models of service delivery. This study investigated the views of cancer clinicians who had experience of a centralized model.

Methods: Interviews were conducted with 16 surgeons and nurses across New South Wales, Australia, who had participated in a trial of a centralized telephone-based supportive care intervention. Content analysis was conducted. Data were analyzed inductively and responses organized into categories and then higher order themes.

Results: All clinicians valued the role of telephone follow ups as they would allow patients to ask questions and receive reassurance. Clinicians believed these services could reduce hospital presentations and provide equity and standardized care, particularly to those outside metropolitan centers. Although clinicians accepted a centralized model of delivery would be cheaper, most (n = 15) indicated a preference for local delivery. This preference was based on the perception that local nurses would have superior knowledge of the local context. Despite the improved feasibility of a telephone-only service, clinicians felt some face-to-face contact with patients was essential. Key at-risk groups to target were identified. Clinicians acknowledged there could be overlap with cancer nurses locally requiring local decisions about implementation.

Conclusion: There was clear endorsement of additional telephone support with a preference for a local model of service delivery. The limited acceptability of centralized telephone-based supportive care interventions may restrict their uptake.