In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 24, No. 18_suppl ( 2006-06-20), p. 18594-18594
Abstract:
18594 Background: Application of quality of life assessment has become an important topic in oncology. Current approaches, however, have focused on technical issues within single center settings overlooking the requirements of routine care. We report on implementing of structural elements of a quality of life diagnostics and therapy system (QoL system). It was designed as integral part of the health care program for breast cancer patients in a regional tumor center. Methods: The QoL system was implemented by a systematic approach (Med. Care, 39, Suppl.2, 2(2001). Its elements comprised (a) coordinating practitioners (CPs) who functioned as gate keepers for QoL related therapies, (b) experts in the QoL unit who provided QoL reports and specific therapeutic recommendations based on patients’ responses to the EORTC questionnaire, (c) professional health care providers in psychotherapy, pain therapy, social support, physiotherapy/lymph drainage, and fitness (nutrition, sports), (d) clinicians (gynecologists) for patient recruitment and (e) opinion leaders for educational influence on the CPs to keep the QoL system in daily practice. Success of implementation (as indicated by CPs’ QoL-related changes in knowledge, attitude and behavior) was evaluated in a prospective study with breast cancer patients. Results: The QoL system was applicable in all of 170 patients recruited between Dec. 2002-June 2004 (age 34–86yrs, UICC 0–4, breast conserving surgery 67%). From 75 CPs (mostly gynecologists) in the area only 39 fulfilled criteria for the QoL system, 1 refused to participate. 38 CPs showed knowledge about QoL following educational outreach visits. Concerning attitudes and behavior, 64% of CPs found the experts’ reports comprehensible, 56% followed their recommendations, 20% made additional actions. Follow-up 4 months after first QoL measurement revealed improvements in pain, body image and social life (p 〈 .05). Conclusion: The study—in combining doctor’s approach and patient’s demands—showed success using methods of guideline implementation by improving QoL deficits within a routine oncological care. Effectiveness will be analyzed in an ongoing randomized trial. No significant financial relationships to disclose.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2006.24.18_suppl.18594
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2006
detail.hit.zdb_id:
2005181-5
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