Risk of unplanned visits for colorectal cancer outpatients receiving chemotherapy: a case-crossover study

Abstract

Chemotherapy exposition triggers the need for unplanned visits over the second and third week after treatment. The prompt and effective management of unexpected events may be cost- and time-saving and reduce pressure on oncology services.

High symptom burden is associated with impaired quality of life in colorectal cancer patients during chemotherapy:A prospective longitudinal study

“…To capture symptoms with paper or electronically based questionnaires are important in order to systematically collect information on the group level. Improved symptom management may reduce the need for hospitalization, [47,188,189] help stabilize or improve QoL, [93,94] and improve the patient's capacity for well-being throughout treatment. [190]…”

“…Such changes have been shown to be important in previous studies of patients with lung cancer [72] and diverse cancer diagnoses [71]; however, they have been studied less in CRC patients. [47] The timing of the assessment points during the chemotherapy cycle is important because various side effects of chemotherapy can occur at different times, [72] and be present for a shorter time period, which means that there is a risk of missing some by infrequent assessments during the course of chemotherapy or only on the day of chemotherapy. [71,72] Assessments after 3 and 7 days provided information about the most acute side effects of chemotherapy, through the chemotherapy cycle, in this cohort.…”

“…[44,45] Previous cancer treatment involving surgery, radiotherapy, and/or chemotherapy may produce late effects after treatment. [46][47][48][49][50][51][52] Surgery of the colon usually does not have a major effect on other organs. Some patients have colostomy, and some patients experience fear of e.g.,…”

“…[35] Symptoms may often change over time, and the use of a longitudinal study design is essential to detecting these fluctuations. [47,60,70,71] Untreated, multiple symptoms can create a vicious cycle and may be an additional burden for cancer patients, which might negatively affect their functioning, rehabilitation, and QoL. [35] Only a limited number of studies with a longitudinal design had assessed multiple symptoms and symptom dimensions in CRC patients before the initiation of this study.…”

SymptomCare@Home

“…1 Poorly controlled symptoms have been shown to adversely affect patient functioning and quality of life 2 and may lead to unplanned visits to the outpatient clinic and emergency department. 3,4 Cancer chemotherapy is primarily delivered in the outpatient setting; thus, patients experience and self-manage treatment-related symptoms at home. Effective symptom monitoring and management at home can be challenging due to the number and varied degree of potential symptoms, the lack of effective communication methods between the patient and healthcare provider, and episodic management practices that are often inconsistent with clinical practice guidelines.…”