Patient reported outcome measures in breast cancer patients

Lagendijk, M.; Egdom, Laurentine S. E. van; Richel, Carol; Leeuwen, Nikki van; Verhoef, Cornelis; Lingsma, Hester F.; Koppert, Linetta B.

doi:10.1016/j.ejso.2018.03.009

Cited by 67 publications

(38 citation statements)

References 20 publications

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“…This may be due in part to the paucity of data on how to measure SDM in a way that is feasible and does not unduly burden patients or clinicians. 41 As patient-reported outcome measures become more common for evaluating cancer patients' treatment experiences, 42,43 our findings may inform best practices around when to survey patients. For example, while it may be desirable to survey breast cancer patients shortly after treatment for certain outcomes of interest, the findings from this study suggest that recall is not compromised when women are surveyed up to 1 year later.…”

Section: Discussionmentioning

confidence: 89%

Impact of Timing on Measurement of Decision Quality and Shared Decision Making: Longitudinal Cohort Study of Breast Cancer Patients

Sepucha

Langford

Belkora³

et al. 2019

Med Decis Making

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Purpose.The objective of this study was to examine whether scores of shared decision-making measures differ when collected shortly after (1 month) or long after (1 year) breast cancer surgical treatment decisions. Methods. Longitudinal, multisite survey of breast cancer (BC) patients, with measurements at 1 month and 1 year after surgery at 4 cancer centers. Patients completed the BC Surgery Decision Quality Instrument (used to generate a knowledge score, ratings of goals, and concordance with treatment preferences) and Shared Decision Making (SDM) Process survey at both time points. We tested several hypotheses related to the scores over time, including whether the scores discriminated between sites that did and did not offer formal decision support services. Exploratory analyses examined factors associated with large increases and decreases in scores over time. Results. Across the 4 sites, 229 patients completed both assessments. The mean total knowledge scores (69.2% [SD 16.6%] at 1 month and 69.4% [SD 17.7%] at 1 year, P = 0.86), SDM Process scores (2.7 [SD 1.1] 1 month v. 2.7 [SD 1.2] 1 year, P = 0.68), and the percentage of patients receiving their preferred treatment (92% at 1 month and 92% at 1 year, P = 1.0) were not significantly different over time. The site using formal decision support had significantly higher knowledge and SDM Process scores at 1 month, and only the SDM Process scores remained significantly higher at 1 year. A significant percentage of patients had large changes in their individual knowledge and SDM Process scores, with increases balancing out decreases. Conclusion. For population-level assessments, it is reasonable to survey BC patients up to a year after the decision, greatly increasing feasibility of measurement. For those evaluating decision support interventions, shorter follow-up is more likely to detect an impact on knowledge scores.

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Section: Discussionmentioning

confidence: 89%

Impact of Timing on Measurement of Decision Quality and Shared Decision Making: Longitudinal Cohort Study of Breast Cancer Patients

Sepucha

Langford

Belkora³

et al. 2019

Med Decis Making

View full text Add to dashboard Cite

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“…The actual proportion of patients with sexuality problems may be higher, as patients may feel uncomfortable reporting these problems [20]. Furthermore, the negative effects of autologous breast reconstruction on arm symptoms, and breast conserving therapy (with additional radiotherapy) on breast symptoms have already been described in the literature [21]. The present study found an association between breast reconstruction and musculoskeletal problems (including arm symptoms), and between radiotherapy treatment and health problems in the breast (including skin problems).…”

Section: Discussionmentioning

confidence: 99%

Patient-reported health problems and healthcare use after treatment for early-stage breast cancer

et al. 2019

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Background: A clear picture of treatment-related health problems following breast cancer treatment is useful in anticipating the informational and other needs of patients during follow-up. This study aimed to identify treatment-related health problems in breast cancer patients up to five years after diagnosis. Secondly, the use of care associated with these health problems was identified. Methods: 876 surgically-treated female patients diagnosed between 2012 and 2016 with early-stage breast cancer were asked to complete an online survey about their current health problems and use of care. Multivariate logistic regression analyses were applied to determine the effect of patient and treatment characteristics on health problems. Results: 404 patients responded (46%). The median age was 62.0 years (SD:10.9). Apart from breast surgery, patients had been treated with radiotherapy (72%), chemotherapy (49%), antihormonal therapy

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“…We corrected for time since diagnosis [6, 39], age [6, 27, 39], presence of comorbid disease(s) [6, 27], and the level of education [6, 27]; these variables were selected based on the literature and availability in our dataset. We also corrected for breast reconstruction, as we expected that this treatment modality had an independent and positive effect on HRQoL [40, 41]. We did not correct for other treatment modalities.…”

Section: Methodsmentioning

confidence: 99%

The impact of health symptoms on health-related quality of life in early-stage breast cancer survivors

Ligt

Heins

Verloop

et al. 2019

Breast Cancer Res Treat

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PurposeIn breast cancer patients, treatment-related health symptoms can occur that may affect their health-related quality of life (HRQoL). This study aimed to determine the impact of health symptoms on HRQoL in breast cancer patients up to 5 years after diagnosis.MethodsFemales surgically treated for early-stage breast cancer diagnosed between 2012 and 2016 (n = 876) were selected from the Netherlands Cancer Registry and invited for a survey about current health symptoms (‘Symptoms and Perceptions questionnaire’, SaP) and HRQoL (‘EORTC-QLQ-C30’). From the latter, functioning and global health were included. Mean scores were compared to norm population scores (T test). Multivariable linear regression analyses were performed to determine the association between health symptoms and global health and functioning.Results404 patients (46%) responded. The median age was 62.2 ± 10.9 years. Respondents had significantly lower mean scores for role, cognitive, emotional, and social functioning than the general population. The most frequently reported health symptoms were musculoskeletal (including pain/complaints in lower/upper extremities/back/neck; 71%) and central nervous system symptoms (including concentration impairment, dizziness, neuralgia; 66%), and fatigue (63%). While most symptoms affected functioning, irrespective of time since diagnosis, especially fatigue, musculoskeletal, central nervous system, and gastrointestinal symptoms were significantly associated (p < 0.05) with lower functioning.ConclusionsThe majority of health symptoms that occur after breast cancer treatment were associated with lower functioning of patients in daily life. This paper urges healthcare providers to support breast cancer patients in alleviating or coping with health symptoms, even years after end of treatment, to improve their functioning.Electronic supplementary materialThe online version of this article (10.1007/s10549-019-05433-3) contains supplementary material, which is available to authorized users.

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Patient reported outcome measures in breast cancer patients

Cited by 67 publications

References 20 publications

Impact of Timing on Measurement of Decision Quality and Shared Decision Making: Longitudinal Cohort Study of Breast Cancer Patients

Impact of Timing on Measurement of Decision Quality and Shared Decision Making: Longitudinal Cohort Study of Breast Cancer Patients

Patient-reported health problems and healthcare use after treatment for early-stage breast cancer

The impact of health symptoms on health-related quality of life in early-stage breast cancer survivors

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