Compliance, attitudes and barriers to post-operative colorectal cancer follow-up
Compliance, attitudes and barriers to post-operative colorectal cancer follow-up
复制标题
DOI：
10.1111/j.1365-2753.2007.00880.x
复制
发表时间：
2008-06-01
影响因子：
2.4
通讯作者：
Wright, Frances
中科院分区：
文献类型：
--
作者：
Cardella, Jonathan;Coburn, Natalie G.;Wright, Frances
原理荟萃分析表明，治疗性结直肠癌（CRC）手术后的监测可以提高生存率。我们的多学科团队在2000年采用了严格的CRC随访（FU）指南。本研究的目的是评估坚持和障碍，以FU为CRC.Methods原发性CRC患者年龄在19-75岁，从2000年7月至2002年12月治疗的根治性手术从一个前瞻性的数据库中确定。主要通过病历审查评估FU依从性。我们还调查了患者和供应商，探讨的态度和障碍，监测坚持使用的原则的健康信念Model.Results 96例患者符合纳入标准，并适合FU。中位随访时间为34个月。70%的门诊访视、49%的癌胚抗原（CEA）测定和62%的腹部影像学检查达到了指南目标。6/93例患者未进行术后结肠镜检查。70%的卫生保健提供者和55%的患者完成了调查。访问测试和混乱的供应商订单调查被确定为重要的障碍FU.Conclusion模式的CRC FU的广泛变化，尽管实施的指导方针。尽管患者和供应商同意CRC FU的原则，但由于多个供应商之间关于调查协调的混乱，采用受到抑制。
Rationale Meta-analyses demonstrate that surveillance following curative-intent colorectal cancer (CRC) surgery can improve survival. Our multidisciplinary team adopted a stringent CRC follow-up (FU) guideline in 2000. The purpose of this study was to assess adherence and barriers to FU for CRC.Methods Patients with primary CRC aged 19-75 years, treated with curative intent surgery from July 2000 to December 2002 were identified from a prospective database. Compliance with FU was assessed primarily by chart review. We also surveyed patients and providers to explore attitudes and barriers to surveillance adherence using tenets of the Health Belief Model.Results 96 patients met inclusion criteria and were appropriate for FU. Median FU was 34 months. Guideline targets were met for 70% of clinic visits; 49% of carcinoembryonic antigen (CEA) determinations; and 62% of abdominal imaging studies. Post-operative colonoscopy did not occur in 6/93 patients. Seventy per cent of health care providers and 55% of patients completed a survey. Access to testing and confusion about which provider orders investigations were identified as important barriers to FU.Conclusion Patterns of CRC FU were widely variable despite implementation of a guideline. Despite patient and provider agreement with the principles of CRC FU, adoption was inhibited by confusion among multiple providers regarding investigation coordination.