Opportunity Costs of Receiving Palliative Chemotherapy for Metastatic Pancreatic Ductal Adenocarcinoma

Bange, Erin; Doucette, Abigail; Gabriel, Peter; Porterfield, Florence; Harrigan, James J; Wang, Robin; Wojcieszynski, Andrzej P.; Boursi, Ben; Mooney, Bethany I; Reiss, Kim A.; Mamtani, Ronac

doi:10.1200/jop.19.00328

Cited by 43 publications

(53 citation statements)

References 18 publications

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“…Cancer care‐related time was calculated using data from all three sources (Figure 1). 11 Ambulatory care time, or time spent on routine care, was calculated using the following equation:

\begin{matrix} Average total ambulatory care time \\ = ({Average time spent traveling to and from clinic}_{survey} \times {Lab rate}_{claims}) \\ + ({Average non-clinic visit infusion time}_{direct observation} \times {Infusion rate}_{claims}) \\ + ({Average clinic visit time}_{direct observation} \times {Clinic visit rate}_{claims}) \\ + ({Average lab time}_{direct observation} \times {Lab rate}_{claims}) \\ + ({Average CT scan time}_{direct observation} \times {CT scan rate}_{claims}) \\ + ({Average bone scan time}_{direct observation} \times {Bone scan rate}_{claims}) . \end{matrix}

…”

Section: Methodsmentioning

confidence: 99%

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Health care‐related time costs in patients with metastatic breast cancer

et al. 2020

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Background: Burdens related to time spent receiving cancer care may be substantial for patients with incurable, life-limiting cancers such as metastatic breast cancer (MBC). Estimates of time spent on health care are needed to inform treatment-related decision-making. Methods: Estimates of time spent receiving cancer-related health care in the initial 3 months of treatment for patients with MBC were calculated using the following data sources: (a) direct observations from a time-in-motion quality improvement evaluation (process mapping); (b) cross-sectional patient surveys; and (c) administrative claims. Average ambulatory, inpatient, and total health care time were calculated for specific treatments which differed by antineoplastic type and administration method, including fulvestrant (injection, hormonal), letrozole (oral, hormonal), capecitabine (oral, chemotherapy), and paclitaxel (infusion, chemotherapy). Results: Average total time spent on health care ranged from 7% to 10% of all days included within the initial 3 months of treatment, depending on treatment. The greatest time contributions were time spent traveling for care and on inpatient services. Time with providers contributed modestly to total care time. Patients receiving infusion/injection treatments, compared with those receiving oral therapy, spent more time in ambulatory care. Health care time was higher for patients receiving chemotherapeutic agents compared to those receiving hormonal agents. Conclusion: Time spent traveling and receiving inpatient care represented a substantial burden to patients with MBC, with variation in time by treatment type and administration method.

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“…Cancer care‐related time was calculated using data from all three sources (Figure 1). 11 Ambulatory care time, or time spent on routine care, was calculated using the following equation:

\begin{matrix} Average total ambulatory care time \\ = ({Average time spent traveling to and from clinic}_{survey} \times {Lab rate}_{claims}) \\ + ({Average non-clinic visit infusion time}_{direct observation} \times {Infusion rate}_{claims}) \\ + ({Average clinic visit time}_{direct observation} \times {Clinic visit rate}_{claims}) \\ + ({Average lab time}_{direct observation} \times {Lab rate}_{claims}) \\ + ({Average CT scan time}_{direct observation} \times {CT scan rate}_{claims}) \\ + ({Average bone scan time}_{direct observation} \times {Bone scan rate}_{claims}) . \end{matrix}

…”

Section: Methodsmentioning

confidence: 99%

“…Cancer care-related time was calculated using data from all three sources ( Figure 1). 11 Ambulatory care time, or time spent on routine care, was calculated using the following equation:…”

Section: Outcome: Patient Health Care Timementioning

confidence: 99%

Health care‐related time costs in patients with metastatic breast cancer

et al. 2020

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“…A retrospective analysis recently suggested that palliative systemic cancer therapy accounted for approximately 10% of the survival time awake remaining to pancreatic cancer patients with distant metastases. 1 Telemedicine applications can facilitate patient access to specialised healthcare from remote and may therefore be ideally suited for the medical oncology setting. With the recent SARS-CoV-2 pandemic the need for…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Completion rate and impact on physician–patient relationship of video consultations in medical oncology: a randomised controlled open-label trial

et al. 2020

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BackgroundMobile phone video call applications generally did not undergo testing in randomised controlled clinical trials prior to their implementation in patient care regarding the rate of successful patient visits and impact on the physician–patient relationship.MethodsThe National Center for Tumour Diseases (NCT) MOBILE trial was a monocentric open-label randomised controlled clinical trial of patients with solid tumours undergoing systemic cancer therapy with need of a follow-up visit with their consulting physician at outpatient clinics. 66 patients were 1:1 randomised to receive either a standard in-person follow-up visit at outpatient clinics or a video call via a mobile phone application. The primary outcome was feasibility defined as the proportion of patients successfully completing the first follow-up visit. Secondary outcomes included success rate of further video calls, time spent by patient and physician, patient satisfaction and quality of physician–patient relationship.FindingsSuccess rate of the first follow-up visit in the intention-to-treat cohort was 87.9% (29 of 33) for in-person visits and 78.8% (26 of 33) for video calls (relative risk: RR 0.90, 95% CI 0.70 to 1.13, p=0.51). The most common reasons for failure were software incompatibility in the video call and no-show in the in-person visit arm. The success rate for further video visits was 91.7% (11 of 12). Standardised patient questionnaires showed significantly decreased total time spent and less direct costs for patients (Δmean −170.8 min, 95% CI −246 min to −95.5 min), p<0.0001; Δmean −€14.37, 95% CI −€23.9 to −€4.8, p<0.005) and comparable time spent for physicians in the video call arm (Δmean 0.5 min, 95% CI −5.4 min to 6.4 min, p=0.86). Physician–patient relationship quality mean scores assessed by a validated standardised questionnaire were higher in the video call arm (1.13-fold, p=0.02).InterpretationFollow-up visits with the tested mobile phone video call application were feasible but software compatibility should be critically evaluated.Trial registration numberDRKS00015788.

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“…Patients may spend a significant amount of time obtaining clinical services. One study demonstrated that over half of clinical visits were spent on commuting and waiting for care [ 17 ]. Time between treatment modalities may be spent on the preparation and planning of the next phase of therapy.…”

Section: Discussionmentioning

confidence: 99%

Real world duration of curative intent breast, colorectal, non-small cell lung, and prostate cancer treatment

Wong

Hamm

Shokoohi³

et al. 2021

BMC Cancer

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Background Advances in curative treatment for breast, colorectal, NSCLC and prostate cancer have led to improvements in cancer survival. Cancer treatment and recovery time can vary depending on the recommended modalities and intensity of therapy. Our objective was to determine the current real world duration of curative treatments for the four common cancers. Methods A retrospective review was completed of patients referred to BC Cancer from 2010 to 2016, ≤ 65 years old, newly diagnosed with stage I-III breast, colorectal, NSCLC or prostate cancer who received curative intent treatment. Information was collected on baseline characteristics, date of diagnosis, surgery, type, duration and intent of both radiotherapy and chemotherapy. Results In total, 22,275 patients were included: 55.7% breast, 22.4% colorectal, 9.2% NSCLC, 12.7% prostate cancer. Stage I/II/III at diagnosis: breast 47.2/38.7/14.1%, colorectal 26.5/30.1/43.5%, NSCLC 46.5/18.1/35.4%, prostate 7.7/62.9/29.4%. Patients treated with definitive surgery only: breast 35.9%, colorectal 58%, NSCLC 52.2%, prostate 40.1%. The median duration of multimodality treatment was breast 24.6 weeks, colorectal 26.7 weeks, NSCLC 9.1 weeks, and prostate 6.0 weeks. Conclusions Approximately half of patients who undergo curative cancer treatment require definitive radiotherapy or multimodality treatment. The median duration of therapy for the most commonly treated cancers ranged from 6.0–26.7 weeks. Multimodality curative treatment can be prolonged for selected cancers when accounting for the duration of adjuvant chemotherapy and radiotherapy and recovery time between modalities.

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Opportunity Costs of Receiving Palliative Chemotherapy for Metastatic Pancreatic Ductal Adenocarcinoma

Cited by 43 publications

References 18 publications

Health care‐related time costs in patients with metastatic breast cancer

Health care‐related time costs in patients with metastatic breast cancer

Completion rate and impact on physician–patient relationship of video consultations in medical oncology: a randomised controlled open-label trial

Real world duration of curative intent breast, colorectal, non-small cell lung, and prostate cancer treatment

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