Is it feasible to routinely include holistic assessment using an item prompt list in surgical consultations following treatment for oral cancer

The head and neck cancer Patients' Concerns Inventory (PCI-HN), is a holistic, self-reported item prompt list that help patients disclose needs and concerns during their routine follow-up consultations. The aim of this study was to report the frequency of PCI use in the first three years of follow-up following oral cancer treatment and to reflect on the type of issues they raised. The sample comprised consecutive oral cancer patients treated over a 3-year period with curative intent. All clinic attendances were reviewed until October 2015 or until one of the following events occurred: recurrence, a subsequent primary, metastases, discharge, the start of palliative care, or discharge to peripheral follow-up. 92 patients were identified with data available for 88. Median (IQR) age at treatment was 65 (57-76) years, and 55% (48) were male. Reviews alternate between surgeon and oncologist and there were on average 4.4 surgical review consultations in year one, 2.8 in year two and 1.6 in year three, with a total of 157 PCIs completed by the cohort. At least one PCI was completed for 71% of attendees during year one, 57% during year two and 37% during year three. Nearly half (41%, 7/17) of those not completing a PCI died within 12 months and another 6 were over 80 years of age. In conclusion, the diversity of concerns highlights the importance of holistic needs assessment as part of follow-up care. By integrating this approach into routine consultations, the majority of patients have the opportunity to repeated intervention.