Implementation of Quality of Life Diagnostics and Therapy
Implementation and Evaluation of Implementation of Quality of Life Diagnostics and Therapy in Individual Patients with Breast Cancer. A prospective study including 170 patients, 5 clinics and 38 general practitioners as coordinating doctors for quality of life therapies. Correlational study including several comparisons such as patients and their doctors.
|Study Design:||Observational Model: Defined Population
Time Perspective: Longitudinal
|Official Title:||Enhancing the Status of Quality of Life Diagnostics in Caring for Breast Cancer Patients: Results From a Multilevel Implementation Study in a Regional Tumor Centre|
|Study Start Date:||December 2002|
|Estimated Study Completion Date:||June 2004|
Improving cancer patients' quality of life (QL) requires that QL-diagnostics, the availability of QL-enhancing treatment options and treatment decisions are being integrated into a clinical path. This description presents the development and implementation of such a clinical path in the Tumorcenter Regensburg.
The acting persons and institutions in this clinical path are the breast cancer patients, the hospitals, the family doctors or gynaecologists, and a QL-study team. Starting point is the QL-assessment either in the hospital or in doctors' practice (EORTC QLQ-C30 plus BR-23). The caring physician documents the patients' health status. Based on these two pieces of information, the QL-study team writes up a medical/QL-opinion plus therapy recommendation. This report is sent to the caring physician. The effectiveness of the therapy recommendation is assessed in the following QL-assessment. This clinical path is implemented via three interrelated methods of implementation: local opinion leaders, outreach visits, and quality circle.
A total of 38 physicians were made familiar with QL-diagnostics through outreach visits, and 12 opinion leaders were identified and convinced to support this project. The quality circle provided regular CME meetings on QL-enhancing therapy options (pain control, psychotherapy, physiotherapy, nutrition, social rehabilitation). A total of 170 QL-reports were sent to physicians. All 38 doctors found the QL-profiles comprehensible and the therapy recommendations clinically relevant. The most common QL-problems were emotional functioning, fatigue, and arm/shoulder problems.
QL-diagnostics is a new way to individualise and to rationalise patient care. It transforms the QL-concept into a decision-relevant, integral part of a clinical path that aims to provide high quality patient care.
|Regensburg, Bavaria, Germany, 93053|
|Study Chair:||Monika KS Klinkhammer-Schalke, MD||Tumorzentrum Regensburg e.V.|
|Principal Investigator:||Michael MK Koller, Ph.D.||University of Marburg, Institut of Theoretical Surgery|
|Principal Investigator:||Brigitte BE Ernst, MD||General Practitioner, Bad Abbach|
|Principal Investigator:||Ferdinand FH Hofstädter, MD, Prof.||Tumorzentrum Regensburg e.V.|
|Principal Investigator:||Wilfried WL Lorenz, MD, Prof.||Tumorzentrum Regensburg e.V.|