AB248. SOH26AB_0385. An evaluation of the acceptability of patient-initiated review (PIR) in sarcoma follow-up: a mixed-methods study
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AB248. SOH26AB_0385. An evaluation of the acceptability of patient-initiated review (PIR) in sarcoma follow-up: a mixed-methods study

Thayumaan Bissoonauth1, Tom McIntyre2, Una Hayden2, Paul Ridgway2

1Discipline of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin, Tallaght University Hospital, Dublin, Ireland; 2Department of Surgery, Tallaght University Hospital, Dublin, Ireland

Background: Follow-up for sarcoma survivors is traditionally delivered via routine, hospital-scheduled clinics. Patient-initiated review (PIR) may reduce low-value visits along with their associated carbon footprint, but evidence of acceptability amongst sarcoma survivors is limited. We evaluated PIR in sarcoma follow-up.

Methods: A mixed-methods study was conducted. Adults on the PIR follow-up pathway completed a cross-sectional survey (n=15; 7 male and 8 female) assessing acceptability, practical benefits, empowerment, and psychological difficulty (1–5 Likert scales). Demographic and travel-distance data were recorded. Semi-structured interviews were undertaken with clinicians (n=5) and patients (n=3) and analysed using thematic analysis.

Results: PIR acceptability was high (4.16±0.58; 12/15 score ≥4). Practical benefits were strongly endorsed (4.49±0.52). All participants agreed that PIR reduced hospital visits (15/15, 100%), most reported reduced travel/time-off-work burden (13/15, 86.7%), and easy team access (14/15, 93.3%). Median distance from sarcoma centre was 150 km; eliminating one visit could avoid 4,400 km of car travel (~0.47 tons CO2). Reversing anxiety items and combining them with a reassurance item yielded a psychological safety composite of 3.28±0.82. An anxiety-only index showed women reported higher anxiety than men (3.50 vs. 2.19, P=0.015), and anxiety increased with greater travel distance (Spearman ρ=0.52, P=0.048). Qualitative themes were: PIR as convenient and time-saving care, access and safety nets as the foundation of acceptability, empowerment vs. burden and anxiety, and the need for clear eligibility criteria and safety nets.

Conclusions: PIR appears to be a feasible and acceptable follow-up model for stable sarcoma survivors, offering a greener alternative with substantial practical benefits and generally low psychological burden, provided it is delivered with strong safety-netting and tailored support for more anxious or remote patients.

Keywords: Green surgery; patient acceptance; patient-initiated review (PIR); sarcoma; self-management

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab248
Cite this abstract as: Bissoonauth T, McIntyre T, Hayden U, Ridgway P. AB248. SOH26AB_0385. An evaluation of the acceptability of patient-initiated review (PIR) in sarcoma follow-up: a mixed-methods study. Mesentery Peritoneum 2026;10:AB248.

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