Patient empowerment by group medical consultations in the follow-up of breast cancer survivors and surveillance of women with a BRCA mutation

A group medical consultation (GMC), or shared medical appointment, is an
innovative way of consultation. During a GMC the healthcare worker provides a
series of one-to-one consultations in a group of ~10 patients; the group is
facilitated by a behavioral health professional. These group appointments
provide patients with the opportunity to spend extended time with their care
providers, while sharing in an interactive setting and learning from other
patients. This may improve patient care compared to an individual consultation.
However, group sessions may also work out negatively and increase patient
distress. Therefore, before introducing GMCs in regular patient care the value
of GMCs for specific patient populations should carefully be evaluated. In this
research project we will evaluate the value of GMCs in the follow-up of breast
cancer survivors and the surveillance of women with a BRCA mutation.

A) Follow-up of breast cancer patients
Primary research question
1.In the follow-up of breast cancer patients: does a group medical consultation
(GMC) increase patient empowerment compared to a regular individual visit
and/or does it decrease psychological distress?

Secondary research questions
1.In the follow-up of breast cancer patients does a GMC compared to a regular
individual visit:
a) decrease fear of breast cancer?
b) improve transfer of information?
c) improve adherence to hormonal treatment?
d) improve patient satisfaction?
e) improve caregiver satisfaction?

2.In the follow-up of breast cancer patients is a GMC cost effective compared
to a regular individual visit?

B) Surveillance of BRCA mutation carriers
Primary research question
1.In the surveillance of women with a BRCA mutation: does a group medical
consultation (GMC) increase patient empowerment compared to a regular
individual visit and/or does it decrease psychological distress?

Secondary research questions
1.In the surveillance of women with a BRCA mutation does a GMC compared to a
regular individual visit:
a) decrease fear of breast cancer?
b) improve transfer of information?
c) improve adherence to self-control of the breasts?
d) change the decision for a prophylactic mastectomy or surveillance?
e) improve patient satisfaction?
f) improve caregiver satisfaction?

2.In the surveillance of women with a BRCA mutation is a GMC cost effective
compared to a regular individual visit?

Two separate randomized controlled trials will be performed for patients in
follow-up after breast cancer and women with a BRCA mutation. In the
experimental group women will participate in a GMC instead of a regular
individual visit; in the control group women will have their regular individual
visit.

GMC versus regular individual consultation

n.a.