Search

Objective: To examine healthcare utilisation and adherence to colorectal cancer (CRC) follow‐up guidelines. Methods: A total of 2450 out of 3025 stage I‐III CRC survivors diagnosed between 2000 and 2009 completed the Hospital Anxiety and Depression Scale, SF‐12, EORTC QLQ‐CR38 and Fatigue Assessment Score questionnaires, in December 2010. Multivariable regression analyses were performed to identify predictors for increased follow‐up care (>1 visit than recommended by guidelines). Results: In the first follow‐up year, the average number of cancer‐related visits to the general practitioner and medical specialist was 1.7 and 4.2, respectively. More than 80% of the CRC survivors was comfortable with their follow‐up schedule, and 49–72% of them received follow‐up according to the guidelines. Around 29–47% was followed more than recommended. Simultaneously, around 4–14% of the CRC survivors received less follow‐up care than recommended. Survivors of stage III disease treated with chemotherapy received the most follow‐up care. In addition, lower socio‐economic status stoma and fatigue were associated with increased follow‐up care. Conclusion: CRC survivors were predominantly followed according to national guidelines. Increased follow‐up care is driven by advanced disease stage, chemotherapy, SES, stoma and fatigue. Future studies should investigate how increased follow‐up care use can be reduced, while still addressing patients' needs. [ABSTRACT FROM AUTHOR]

This study evaluates feasibility of a multidisciplinary intervention combining occupational counselling with physical exercise to enhance cancer patients’ return to work, assesses whether care providers and patients were satisfied with the intervention, and describes barriers to and facilitators of execution. Newly diagnosed cancer patients, treated with chemotherapy and on sick leave from (self‐)employment participated. Patients received counselling from an oncological occupational physician (OOP), were assessed by a sports physician, and performed a 12‐week training programme supervised by physiotherapists. Care providers completed registration forms to collect data on reach, dose delivered and received in executing the protocol and were interviewed about their satisfaction and barriers to and facilitators of execution. Patients completed three questionnaires on satisfaction and usefulness of the intervention. Fifty‐six per cent of all patients were eligible (reach). In total, 123 patients participated. For all intervention components dose delivered exceeded 75%; dose received ranged from 49%–79%. Overall, patients and care providers were satisfied and perceived the intervention as useful. Care providers considered the intervention feasible, while execution was facilitated by highly motivated patients and impeded by physical limitations hindering exercise. It is feasible to conduct this multidisciplinary intervention in cancer patients during curative treatment. Patients and care providers were satisfied with the intervention. [ABSTRACT FROM AUTHOR]

Treatment of metastatic soft tissue sarcoma ( mSTS) commonly includes multiple lines of chemotherapy, until a decline in performance status precludes further treatment. The primary objective of this study was to describe the lifetime healthcare resource utilisation and cost among mSTS patients with favourable response to chemotherapy. SABINE was a multi-centre ( n = 25), multi-country ( n = 9) retrospective chart review study of mSTS patients with favourable response to chemotherapy following 4 cycles. Healthcare resource utilisation was collected from first line until death or end of follow-up. Costs were analysed by health states (defined by treatment line, chemotherapy use and disease progression) and estimated by multiplying the mean weekly cost per health state by the expected number of weeks spent in each health state. Expected per-patient lifetime medical cost was €65 616 (95% CI: €51 454-€85 003); comprised of IV chemotherapy (31.7%), inpatient care (24.8%), concomitant medication (11.0%), oral chemotherapy (8.9%), outpatient visits (8.8%), radiotherapy (6.3%), hospice (4.0%), imaging (3.7%) and laboratory (0.7%). Weekly costs were 280-330% higher during chemotherapy treatment periods than off-chemotherapy, especially after disease progression. Per-patient costs were highest in the USA and lowest in the Netherlands and UK. The economic burden of mSTS is considerable and the amount of resources devoted to its treatment varies across countries. [ABSTRACT FROM AUTHOR]