Artikel
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
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Autoren
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M. Klinkhammer-Schalke
- Tumor Center Regensburg e.V., Regensburg, Germany
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P. Lindberg
- Tumor Center Regensburg e.V., Regensburg, Germany
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B. Steinger
- Tumor Center Regensburg e.V., Regensburg, Germany
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M. Koller
- Center for Clinical Trials, University Hospital, Regensburg, Germany
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J. Wyatt
- Institute for Digital Healthcare, Warwick, UK
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F. Hofstädter
- Institue of Pathology, University Regensburg, Regensburg, Germany
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W. Lorenz
- Tumor Center Regensburg e.V., Regensburg, Germany
| Veröffentlicht: | 10. Juli 2012 |
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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.
