ADAPT: Managed local follow-up of long-term cancer survivors
Even when a person has managed to beat cancer, it is unfortunately the case that other health problems can arise in future years due to the treatments they received. There is an urgent need to address this issue with measures to track, trace and manage the late consequences of cancer treatment to maximise the duration and quality of survival after the cancer cure.
Professor John Radford and colleagues at the Christie Hospital in Manchester have developed a strategy for managing cancer patients 5+years from treatment when the risk of cancer recurrence is low but patients are at risk of other multiple health issues because of the late effects of their previous treatment for cancer. The intervention, called ADAPT, provides patients and GPs with individualised information about diagnosis, treatment, possible late consequences and how these can be recognised, mitigated and managed.
So far 826 patients have been ADAPTed at the Christie with very good feedback from patients and GPs. The team estimate that for this number of patients ADAPT will save 826 hospital appointments, £172,000 and 1 working year of patient time per annum recurrently. From April 2018 health service commissioners have provided funding for infrastructure support based on 33% of the savings made. ADAPT has been integrated into PINGR (a GP electronic patient record) and implemented across Salford.
In collaboration with Professor Niels Peek (NIHR Greater Manchester PSTRC and NIHR Greater Manchester ARC) and Professor Stephen Campbell (NIHR Greater Manchester PSTRC) the team are now creating a digital platform, e-ADAPT. This will provide a patient-facing website/app and be widely applicable. They are planning to integrate other interventions into e-ADAPT, such as a digital patient prompts when a blood test is required to check thyroid gland function following radiotherapy to the neck. They are also working with colleagues at the NIHR Greater Manchester ARC to evaluate the health economic impact of ADAPT and design the best way of integrating ADAPT into routine clinical practice.