Table 6.

Non-randomised study details and study outcomes

Study author (type of study)	Participants (n), type of cancer, stage of cancer care continuum	Description of study	Results
Aljarabah et al, 2009, UK28 (Prospective)	n=3 clinical consultants (receiving GPs’ referral letters for 217 patients) Colorectal; Diagnosis	Intervention: (Referral letters) Clinical consultants’ assessment of the reliability of GPs’ referral letters for allowing patients to proceed ‘straight-to-test’ Control: None Data collection methods: Prospective collection of clinical consultants' recommendations for diagnostic test referrals based on both GP letter and postpatient consultation Outcome(s) measured: Consultants’ diagnostic test referrals	The diagnostic tests that were recommended by clinical consultants having only read GPs’ referral letters differed from those that they would have recommended having performed an in-person clinical consultation for 31% of patients. Therefore, suspected patients with colorectal cancer should be seen in a clinic by an expert before proceeding to testing.
Baliski et al, 2014, Canada29 (Cohort)	n=97 current patients (and 100 patients from previous years) Breast; Diagnosis into treatment	Intervention: (Nurse navigation) Implementation of a nurse navigation programme Control: None Data collection methods: Prospective records database, and wait time records from BC Cancer Agency Sindi Ahluwalia Hawkins Centre for the Southern Interior and Kelowna General Hospital (from previous years) Primary outcome(s): Surgical wait times	Wait times for surgery decreased with the introduction of the programme (median of 59 vs 48 days); however, this decrease was not statistically significant. The need for MRI was found to significantly influence wait times by delaying surgery.
Blinder et al, 2013, USA30 (Prospective)	n=174 patients (completed at least one survey) Breast; Diagnosis into treatment	Intervention: (TPSs) Seven oncology practices from the ASCO membership were instructed to offer all patients TPSs and to discuss them with the patients. Patients receiving chemotherapy received the plan and summary documents separately (at the beginning and end of treatment, respectively). All other patients received a single integrated TPS. Control: None Data collection methods: Telephone surveys Outcome(s) measured: Quality of care, coordination of care and patient satisfaction	Of all patients who recalled receiving TPSs, 94% believed that the documents improved patient–physician communication (quality of care) and 82% believed that they improved communication between physicians (coordination of care). Participants expressed high satisfaction with TPSs. Of patients who still had their documents, 97% said they were useful (patient satisfaction).
Dulko et al, 2013, USA31 (Descriptive)	n=17 APPs, 39 PCPs and 58 patients participated Breast and colorectal; Survivorship	Intervention: (SCPs) Evaluating the process of SCP completion and assessing the barriers to SCP creation and implementation Control: None Data collection methods: Self-administered questionnaires and telephone interviews Outcome(s) measured: Usefulness and barriers to SCP development, challenges to development and implementation of SCPs, and patient perceptions of the SCP visit	Fifty-eight per cent of PCPs identified inadequate knowledge of cancer survivor issues as a barrier to SCP implementation and 64% identified limited access to patients as a barrier to providing follow-up care. The primary barrier to SCP completion, identified by APPs, was the time required to prepare a SCP (the average time needed was 53.9 min). More than half of the patients surveyed did not know what to expect from their SPC visit; 64% of patients seen within 6 months of diagnosis (and 55% of patients seen at 7–12 months after diagnosis) agreed that the SCP was given to them at an appropriate time.
Hall et al, 2011, UK32 (Cross-sectional)	n=23 patients and 5 GPs participated Breast, colorectal, gastrointenstinal, prostate and melanoma; Survivorship	Intervention: (Shared follow-up care) Assessment of opinions regarding shared-care and conducting a shared-care modelling exercise Control: none Data collection methods: Telephone or in-person interviews and shared follow-up modelling exercise Outcome(s) measured: Opinions regarding shared follow-up care	Most patients and GPs had a positive outlook on shared follow-up care. Patients perceived the benefits of shared follow-up care to be improved access, convenience, travel time and continuity of care; they agreed that GPs who provide shared care should be specially trained and that shared-care must be supported by secondary care. GPs emphasised the importance of maintaining their clinical skills and receiving strong administrative support.
Jefford et al, 2011, Australia33 (Prospective)	n=10 patients (baseline); 8 patients* Colorectal; Survivorship	Intervention: (Nurse-led care) Implementation of nurse-led post-treatment intervention Control: None Data collection methods: Self-administered questionnaires, and in-person and telephone interviews Outcome(s) measured: Patient satisfaction	Overall, patients considered the nurse-led intervention to be appropriate, relevant, and useful. All participants agreed that nurse-led treatment sessions addressed their concerns and clarified information, and that the phone calls were informative, reassuring and allowed for continued contact with the hospital (which was deemed important).
Jiwa et al, 2013, Australia34 (Prospective)	n=21 patients (baseline); 19 patients* Breast; Survivorship	Intervention: (Cancer care coordination) Evaluation of the benefits of therapeutic action delivered to patients by GPs (therapeutic action was based on the recommendations of a primary care-led multidisciplinary team, who had received the patient's needs assessment) Control: None Data collection methods: Self-administered questionnaires and telephone conversations Outcome(s) measured: Physical and psychological patient outcomes	Questionnaire responses showed no statistically significant difference in physical or psychological patient outcomes. However, the majority of participants (11/17 women who had visited their GPs) reported that their condition had improved as a result of the primary care-led intervention.
Knowles et al, 2007, UK35 (Prospective)	n=80 patients (baseline); 60 patients* Colorectal; Survivorship	Intervention: (Nurse-led follow-up care) Assessment of the feasibility of a nurse-led follow-up programme over the course of 1 year Control: None Data collection methods: Access database, patients’ case notes, self-administered questionnaires Outcome(s) measured: Adherence to follow-up protocol; detection of recurrence; quality of life; patient and clinician satisfaction; cost savings analysis	Over the course of 1 year, nurse adherence to protocol was strict and resulted in recurrence being detected in 10 patients. Furthermore, patients’ quality of life significantly improved throughout the study period. The programme was acceptable to both patients and care providers, and the presence of nurses provided an added benefit of streamlining services and reducing the burden on outpatient resources. The assumed cost savings over a 3-year follow-up period (supposing a steady rate of 220 new patients annually) was estimated to be £28 030.
McFarlane et al, 2012, New Zealand36 (Prospective)	n=950 patients, tracked for 7 years Colorectal; Survivorship	Intervention: (Nurse-led follow-up care) Documentation of the results of a nurse-led follow-up clinic over the course of 7 years Control: None Data collection methods: Patient details recorded prospectively in a database Outcome(s) measured: Patient health outcomes and process outcomes	Over the course of 7 years, 368 patients were discharged, 474 remained actively involved in the programme and 108 died. Of those who were discharged, 73% returned to the care of their GP, free of disease. Twenty patients were identified as having disease recurrence and 93 as having distant metastatic disease; of these, 65 were referred to palliative care and 28 had surgery. Overall, the clinic's detection rates of recurrent or metastatic disease were comparable to surgical consultant follow-up.
Sprague et al, 2013, USA37 (Cross-sectional)	n=78 patients (baseline); 58 patients* Breast and colorectal; Survivorship	Intervention: (SCPs) Evaluation of patient satisfaction with SCPs Control: None Data collection methods: Telephone interviews Outcome(s) measured: Patient satisfaction	Ninety-one per cent of patients agreed that the SCP they received was useful, easy to understand, and that the length was appropriate. Nineteen per cent stated that they would need help in using the plan. The majority agreed that the SCP was very or critically important to understanding survivorship issues; however, only about half of all patients felt that the SCP helped them to understand the individual roles of, and the collaborative relationship between, PCPs and oncologists.
Vanhuyse et al, 2007, Canada38 (Cross-sectional)	n=193 patients, tracked over the course of 4 months Breast; Survivorship	Intervention: (Transfer of follow-up care) Prospective programme of planned patient transfer to a PCP for follow-up Control: None Data collection methods: Patient details recorded prospectively in a database Outcome(s) measured: Number of patients for whom transfer back to a PCP for follow-up care was feasible	Transfer was deemed suitable for 43% of all patients assessed for transfer. This strategy of safely assessing follow-up patients for transfer to primary care may help in allowing oncologists to focus on primarily caring for newly diagnosed and advanced-stage patients.

*Number of patients who completed the study.

APP, advanced practice professional; ASCO, American Society of Clinical Oncology; BC, British Columbia; GP, general practitioner; PCP, primary care provider; SCP, survivorship care plan; TPS, treatment plan and summary.