Comorbidity in lung cancer patients and its association with medical service cost and treatment choice in China

Ding, Ruoxi; Zhu, Dawei; He, Ping; Ma, Yong; Zhi-shui, Chen; Shi, Xuefeng

doi:10.1186/s12885-020-06759-8

Cited by 26 publications

(28 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, a German study reflects that every additional comorbidity to an index disease is associated with an increase by the factor of 2.3 in medical contacts. Consequently, the number of comorbidities is associated with a significant increase in physician contacts compared to patients without comorbidity 17 . Considering that in 2007 the number of physician contacts for all statutory insured people in Germany was 17 18 , the disease burden of patients with lung cancer is underlined by the fact that they visited an outpatient care provider 35 times and have a CCI about 6.…”

Section: Discussionmentioning

confidence: 99%

Lung cancer patients’ comorbidities and attendance of German ambulatory physicians in a 5-year cross-sectional study

Bossert

Ludwig

Wronski

et al. 2021

npj Prim. Care Respir. Med.

View full text Add to dashboard Cite

The majority of lung cancer patients are diagnosed with an advanced stage IV, which has short survival time. Many lung cancer patients have comorbidities, which influence treatment and patients’ quality of life. The aim of the study is to describe comorbidities in incident lung cancer patients and explore their attendance of ambulatory care physicians in Germany. In the observed period, 13,111 persons were first diagnosed with lung cancer (1-year incidence of 36.4 per 100,000). The mean number of comorbidities over 4 quarters was 30.77 ± 13.18; mean Charlson Comorbidity Index was 6.66 ± 2.24. In Germany, ambulatory care physicians most attended were general practitioners (2.6 quarters with contact within 4 quarters). Lung cancer was diagnosed by a general practitioner in 38% of the 13,111 incident patients. The average number of ambulatory care physician contacts over 4 quarters was 35.82 ± 27.31. High numbers of comorbidities and contacts in ambulatory care are common in patients with lung cancer. Therefore, a cross-sectoral and interdisciplinary approach is required for effective, patient-centred care. This was a 5-year cross-sectoral study, based on the InGef research database, which covers anonymized health insurance data of 7.2 million individuals in Germany. Incident lung cancer patients in a 5-year period (2013–2017) were identified. Descriptive statistics were calculated for sociodemographic characteristics, comorbidities, and attendance of ambulatory care physicians.

show abstract

Section: Discussionmentioning

confidence: 99%

Lung cancer patients’ comorbidities and attendance of German ambulatory physicians in a 5-year cross-sectional study

Bossert

Ludwig

Wronski

et al. 2021

npj Prim. Care Respir. Med.

View full text Add to dashboard Cite

show abstract

“…Patients diagnosed with lung cancer usually experience significant medical service utilization [ 37 ]. In clinical practice, IIV of Endostar has increased intravenous admixture workload of nursing staff, as Endostar should be diluted in 500 mL of normal saline daily for a duration of 14 days in each treatment cycle.…”

Section: Discussionmentioning

confidence: 99%

“…Lung cancer is one of the major contributors to cancer-caused DALYs in most countries, and has imposed a substantial disease burden to global public health [ 42 , 43 ]. China has experienced a noteworthy increase in the relative disease burden caused by lung cancer, with 12% of total DALYs from cancers in 1990 to 20% in 2008 [ 43 ], and is now facing up with severe predicament of lung cancer burden [ 37 ]. Currently, Endostar has been widely used in combination with first-line chemotherapy for advanced NSCLC in China.…”

Section: Discussionmentioning

confidence: 99%

Endostar continuous versus intermittent intravenous infusion combined with chemotherapy for advanced NSCLC: a systematic review and meta-analysis including non-randomized studies

Wang¹,

Li³

et al. 2020

BMC Cancer

View full text Add to dashboard Cite

Background Both intermittent intravenous (IIV) infusion and continuous intravenous (CIV) infusion of Endostar are widely used for NSCLC in China. We aimed to compare the efficacy and safety of CIV of Endostar versus IIV in combination with first-line chemotherapy for patients with advanced NSCLC. Methods RCTs, NRCTs and cohort studies which compared CIV of Endostar with IIV in advanced NSCLC patients and reported efficacy or safety outcomes were eligible. Two reviewers independently screened records, extracted data and assessed risk of bias. Pooled risk ratios (RRs) with 95% confidence intervals were calculated using random effects meta-analysis for short-term efficacy and safety outcomes, and hazard ratios (HRs) for survival outcomes. Results Finally nine studies involving 597 patients were included, containing two RCTs, three NRCTs and four cohort studies. For short-term efficacy, moderate quality of evidence showed that there were no significant differences between CIV of Endostar and IIV in objective response rate (ORR; RR 1.34, 95% CI 0.91–1.98, P = 0.14) and disease control rate (DCR; RR 1.11, 95% CI 0.94–1.30, P = 0.21). Very low quality of evidence indicated that CIV of Endostar significantly improved both overall survival (OS; HR 0.69, 95% CI 0.48–0.99, P = 0.046) and progression-free survival (PFS; HR 0.71, 95% CI 0.55–0.93, P = 0.01) compared with IIV. As for safety outcomes, moderate quality of evidence found that CIV of Endostar significantly reduced the risk of myelosuppression (RR 0.55, 95% CI 0.32–0.96, P = 0.03) and cardiovascular toxicity (RR 0.21, 95% CI 0.06–0.78, P = 0.02) compared with IIV. Conclusions In advanced NSCLC, compared with IIV, CIV of Endostar had similar short-term efficacy, and substantially lower risk of myelosuppression and cardiovascular toxicity. Although very low quality of evidence supported the survival benefit of CIV compared with IIV, large RCTs with long-term follow-up are needed to demonstrate survival benefits. Caution should be given for off-label use of CIV of Endostar.

show abstract

“…The diagnosis of comorbidity is complex, long‐lasting, and uncertain due to the lack of appropriate coping strategies and the estimation of prognosis. Ding et al (2020) surveyed 8655 patients with lung cancer and found that 31.3% of them had at least one comorbid condition. Comorbidities aggravate the complexity of lung cancer management, and multiple comorbidities limit potential treatment options, thereby adding a significant medical burden.…”

Section: Introductionmentioning

confidence: 99%

“…The diagnosis of comorbidity is complex, long-lasting, and uncertain due to the lack of appropriate coping strategies and the estimation of prognosis. Ding et al (2020) surveyed 8655 patients with lung cancer and found that 31.3% of them had at least one comorbid condition.…”

Section: Introductionmentioning

confidence: 99%

Clinical traits of patients with major depressive disorder with comorbid borderline personality disorder based on propensity score matching

Tong

Shi

et al. 2020

Depression and Anxiety

View full text Add to dashboard Cite

Background: Major depressive disorder (MDD) with comorbid borderline personality disorder (BPD) makes the clinical symptoms of patients more complex and more difficult to treat, so more attention should be paid to the recognition of their clinical features. This study investigated the differences between patients with MDD with and without BPD in clinical traits. Methods: Propensity score matching was used to analyze the retrospective patients' data from August 2012 to September 2019. Altogether, 1381 patients with MDD were enrolled; 38 patients with MDD were matched to compare demographic data, and scores on the Hamilton Depression Scale, Hamilton Anxiety Scale (HAMA), Self-Rating Depression Scale (SDS), Modified Overt Aggression Scale (MOAS), and the frequency of nonsuicidal self-harm (NSSH). Results: Compared to patients with MDD without BPD, the age of onset of patients with MDD with comorbid BPD was significantly earlier (t = 3.25, p = .00). The scores of HAMA (t = −2.28, p = .03), SDS (t = 9.31, p = .00), MOAS (t = −13.67, p = .00), verbal aggression (t = −3.79, p = .00), aggression against objects (t = −2.84, p = .00), aggression against others (t = −6.70, p = .00), and aggression against self (t = −9.22, p = .00) were significantly higher in patients with MDD with comorbid BPD. Moreover, the frequency of NHSS in these patients was significantly higher (χ 2 = 20.13, p = .00). MOAS was an independent influencing factor in these (odds ratio = 7.38, p = .00).

show abstract

Comorbidity in lung cancer patients and its association with medical service cost and treatment choice in China

Cited by 26 publications

References 28 publications

Lung cancer patients’ comorbidities and attendance of German ambulatory physicians in a 5-year cross-sectional study

Lung cancer patients’ comorbidities and attendance of German ambulatory physicians in a 5-year cross-sectional study

Endostar continuous versus intermittent intravenous infusion combined with chemotherapy for advanced NSCLC: a systematic review and meta-analysis including non-randomized studies

Clinical traits of patients with major depressive disorder with comorbid borderline personality disorder based on propensity score matching

Contact Info

Product

Resources

About