The impact of the survivorship care plan on health care use: 2-year follow-up results of the ROGY care trial
The impact of the survivorship care plan on health care use: 2-year follow-up results of the ROGY care trial
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DOI：
10.1007/s11764-017-0639-7
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发表时间：
2018-02-01
影响因子：
3.7
通讯作者：
van de Poll-Franse, Lonneke V.
中科院分区：
文献类型：
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作者：
Jeppesen, Mette Moustgaard;Ezendam, Nicole P. M.;van de Poll-Franse, Lonneke V.
本研究的目的是评估存活护理计划（SCP）的提供及调节因素对子宫内膜癌治疗后医疗保健使用的影响。新诊断为子宫内膜癌的妇女被纳入荷兰12家医院的实用群随机试验，并被随机分配到SCP或常规护理组（n = 221； 75%应答）。SCP使用基于网络的注册系统肿瘤学妇科（ROGY）生成，并提供有关疾病、治疗和可能的后期效应的定制信息。通过诊断后以及6个月、12个月和24个月的随访问卷收集与癌症相关的全科医生、专科医生和额外医疗保健的使用情况，并使用线性多水平回归分析进行比较。在诊断后的第一年，接受SCP治疗的妇女与常规治疗组相比，有更多的癌症相关初级保健就诊（β = 0.7, p < 0.01）。在6个月的随访中，与接受常规护理的妇女相比，SCP组的妇女使用了更多的额外保健（24%对11%，p = 0.04）。有焦虑症状的妇女（p = 0.03）和接受放射治疗的妇女（p = 0.01）在接受SCP治疗后的第一年内有更高的初级保健使用率。SCP增加了治疗后第一年的初级保健消费，特别是接受放射治疗的妇女和有焦虑症状的妇女。这些发现表明，SCP使需要支持性护理的妇女能够在治疗后的早期阶段寻求相关护理。这是否会改善患者报告的长期结果需要进一步研究。
The purpose of this paper was to assess the impact of survivorship care plan (SCP) provision and moderating factors on health care use following endometrial cancer treatment.Women newly diagnosed with endometrial cancer were included in a pragmatic cluster randomized trial at 12 hospitals in the Netherlands and were randomly assigned to SCP or usual care (n = 221; 75% response). The SCP was generated using the web-based Registrationsystem Oncological GYnecology (ROGY) and provided tailored information regarding disease, treatment, and possible late-effects. Cancer-related use of general practitioner, specialist, and additional health care was collected through questionnaires after diagnosis and at 6-, 12-, and 24-month follow-up and compared using linear multilevel regression analyses.Women who received an SCP had more cancer-related primary care visits compared to the usual care arm during the first year after diagnosis (beta = 0.7, p < 0.01). At 6-month follow-up, women in the SCP group used more additional health care compared to women receiving usual care (24 vs. 11%, p = 0.04). Women with anxious symptoms (p = 0.03) and women who received radiotherapy (p = 0.01) had a higher primary care use within the first year after treatment, when receiving an SCP.The SCP increases primary health care consumption the first year after treatment, particularly in women treated with radiotherapy and women with anxious symptoms.These findings imply that the SCP enables women in need of supportive care to seek relevant care at an early stage after treatment. Whether this results in improved patient-reported outcomes in the long-term needs to be further studied.