BMC cancer · 2011
Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?
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Lu Wenli, Jansen Liesbeth, Schaapveld Michael, Baas Peter C, Wiggers Theo, De Bock Geertruida H
Аннотация
BACKGROUND: After primary treatment for breast cancer, patients are recommended to use hospital follow-up care routinely. Long-term data on the utilization of this follow-up care are relatively rare.
METHODS: Information regarding the utilization of routine hospital follow-up care was retrieved from hospital documents of 662 patients treated for breast cancer. Utilization of hospital follow-up care was defined as the use of follow-up care according to the guidelines in that period of time. Determinants of hospital follow up care were evaluated with multivariate analysis by generalized estimating equations (GEE).
RESULTS: The median follow-up time was 9.0 (0.3-18.1) years. At fifth and tenth year after diagnosis, 16.1% and 33.5% of the patients had less follow-up visits than recommended in the national guideline, and 33.1% and 40.4% had less frequent mammography than recommended. Less frequent mammography was found in older patients (age > 70; OR: 2.10; 95%CI: 1.62-2.74), patients with comorbidity (OR: 1.26; 95%CI: 1.05-1.52) and patients using hormonal therapy (OR: 1.51; 95%CI: 1.01-2.25).
CONCLUSIONS: Most patients with a history of breast cancer use hospital follow-up care according to the guidelines. In older patients, patients with comorbidity and patients receiving hormonal therapy yearly mammography is performed much less than recommended.
METHODS: Information regarding the utilization of routine hospital follow-up care was retrieved from hospital documents of 662 patients treated for breast cancer. Utilization of hospital follow-up care was defined as the use of follow-up care according to the guidelines in that period of time. Determinants of hospital follow up care were evaluated with multivariate analysis by generalized estimating equations (GEE).
RESULTS: The median follow-up time was 9.0 (0.3-18.1) years. At fifth and tenth year after diagnosis, 16.1% and 33.5% of the patients had less follow-up visits than recommended in the national guideline, and 33.1% and 40.4% had less frequent mammography than recommended. Less frequent mammography was found in older patients (age > 70; OR: 2.10; 95%CI: 1.62-2.74), patients with comorbidity (OR: 1.26; 95%CI: 1.05-1.52) and patients using hormonal therapy (OR: 1.51; 95%CI: 1.01-2.25).
CONCLUSIONS: Most patients with a history of breast cancer use hospital follow-up care according to the guidelines. In older patients, patients with comorbidity and patients receiving hormonal therapy yearly mammography is performed much less than recommended.
Предметные рубрики MeSH
AdultAftercareAgedAged, 80 and overAntineoplastic Agents, HormonalBreast NeoplasmsCohort StudiesCombined Modality TherapyComorbidityFemaleFollow-Up StudiesGuideline AdherenceHealth Care SurveysHumansMammographyMatched-Pair AnalysisMiddle AgedNeoplasms, Second PrimaryNetherlandsOutpatient Clinics, HospitalPatient Acceptance of Health CarePatient CompliancePractice Guidelines as Topic