gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Effectiveness of quality-of-life diagnosis and therapy according to follow-up recommended by S3 guideline for breast cancer: Results of an RCT on patients with breast cancer

Meeting Abstract

  • M. Klinkhammer-Schalke - Tumor Center Regensburg e.V., Regensburg, Germany
  • P. Lindberg - Tumor Center Regensburg e.V., Regensburg, Germany
  • B. Steinger - Tumor Center Regensburg e.V., Regensburg, Germany
  • M. Koller - Center for Clinical Trials, University Hospital, Regensburg, Germany
  • J. Wyatt - Institute for Digital Healthcare, Warwick, UK
  • F. Hofstädter - Institue of Pathology, University Regensburg, Regensburg, Germany
  • W. Lorenz - Tumor Center Regensburg e.V., Regensburg, Germany

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO55

DOI: 10.3205/12gin087, URN: urn:nbn:de:0183-12gin0875

Veröffentlicht: 10. Juli 2012

© 2012 Klinkhammer-Schalke et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Background: German national guideline for breast cancer recommends regular diagnosis of quality-of-life (QoL) during follow-up. We developed and implemented a QoL-pathway with systematic QoL-diagnosis and treatment.

Objectives: Improving QoL in breast cancer patients during follow-up with QoL-pathway.

Methods: RCT with 200 female primary breast cancer patients. Both groups were treated according to German national guideline for breast cancer. QoL was measured prospectively (EORTC QLQ-C30+BR23) in the first postoperative year every 3 months during routine follow-up recommended by national guideline. For intervention group (IG) coordinating practitioners additionally received QoL-profile consisting of 10 dimensions (e.g. arm symptoms, pain, emotion, physical functioning) and expert-report with recommendations for treatment of diseased-QoL.

Results: Overall effectiveness of QoL-pathway at 6 months is primarily attributable to effects of psychotherapy with IG showing significantly lower rates of diseased-QoL in emotion compared to CG (19.8%vs.38.4%, p=.007). Regarding rates of diseased-QoL for physiotherapy (arm symptoms: 13.8%vs.23.3%, p=.109), pain therapy (pain: 19.5%vs.24.4%; p=.438), and nutrition/fitness (physical functioning: 4.7%vs.5.7%; p=.746) there was a trend showing lower rates of diseased-QoL in IG.

Discussion: QoL of breast cancer patients can be improved by targeted treatment of QoL-deficits. For this purpose we need regional networks of professional health care providers and integration of evidence-based QoL-therapy into follow-up of medical guideline recommendations.

Implications for guideline developers/users: There is a need to anchor applicable recommendations for QoL-diagnosis and treatment in breast cancer guideline. Benefits for patients were demonstrated by QoL-pathway.