The authors identified that nurses need to explore patients' expectations of treatment rather than rigidly following the care pathways.
Recommendations from the study include:
a holistic nursing assessment including an section that identifies what the patient is looking for from the clinic;
patients who have previously failed therapy should be encouraged to discuss their options;
this may deviate from the pathway;
are pathways should only be used as a guide to care;
the option of house calls or evening surgeries to improve access to services should be considered;
patients who drop out of therapy should receive a standard letter advising them that they can telephone to discuss further options with a nurse.