The impact of patient-reported outcomes on loss to follow-up care after bariatric surgery

Total Ankle Arthroplasty ◽

Linear Regression Models ◽

Ankle Arthroplasty ◽

Change Scores ◽

Short Musculoskeletal Function Assessment ◽

Patient Reported ◽

Category: Ankle Introduction/Purpose: Poor pre-operative mental health and depression have been shown to negatively impact patient- reported outcomes (PROMs) after a broad array of orthopaedic procedures involving the spine, hip, knee, shoulder, and hand. However, the relationship of mental health and patient-reported outcomes in foot and ankle surgery is less clear. The purpose of this study is to characterize the impact of pre-operative mental health and depression on patient-reported outcomes after total ankle arthroplasty. The study hypothesis is that depression and decreased SF36 MCS will be significantly associated with diminished improvement in PROMs after total ankle arthroplasty. Methods: All patients undergoing primary TAA between January 2007 and December 2016 who were enrolled into a prospective, observational study and who had at least 1 to 2-year minimum study follow-up were included. Patients were separated into 4 groups based on the presence or absence of SF36 MCS<35 and diagnosis of depression. Pre-operative to post- operative change scores in the SF36 physical and mental component summary scores (PCS and MCS), Short Musculoskeletal Function Assessment (SMFA) function and bother components, and visual analog scale (VAS) pain were calculated in 1 to 2-year follow-up. Multivariable, main effects linear regression models were constructed to evaluate the impact of SF36 and depression status on pre-operative to 1 to 2-year follow-up change scores with adjustment for age, sex, race, body mass index, current smoking, American Society of Anesthesiologist’s score, smoking, and Charlson-Deyo comorbidity score. Results: As in Table 1, adjusted analyses demonstrated that patients with MCS<35 and depression had significantly lower improvements in all change scores including SF36 MCS (-5.1 points) and PCS (-7.6 points), SMFA bother (6 points) and function scores (5.7 points), and VAS pain (7.5 points) compared with patients that had SF36>=35 and no depression. Patients with MCS<35 and no depression had significantly greater improvement in SF36 MCS (5.3 points) compared with patients that had MCS>=35 and no depression. Patients with MCS>=35 and depression had significantly lower improvement in SF36 MCS (-3.2 points) compared with patients that had MCS>=35 and no depression. Adjusted analyses of minimum 5-year outcomes demonstrated significantly increased improvement in MCS and SMFA function for patients with pre-operative MCS<35 and no depression. Conclusion: Presence of depression and decreased SF36 MCS are risk factors for diminished improvement in PROMs. Patients with depression and decreased MCS should be counseled about their risk of diminished improvement in outcomes compared to peers. As PROM’s become part of physician evaluations, it is becoming increasingly important to identify factors for diminished improvement outside of the physician’s control. [Table: see text]

Improvement in patient-reported outcomes in Chinese adults after bariatric surgery: 1-year follow-up of a prospective cohort

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2020.04.050 ◽

2020 ◽

Vol 16 (10) ◽

pp. 1563-1572

Author(s):

Yihui Wei ◽

Tingting Wu ◽

Daniel K.H. Tong ◽

Betty T.T. Law ◽

David K.W. Leung ◽

...

Keyword(s):

Bariatric Surgery ◽

Prospective Cohort ◽

Chinese Adults ◽

Patient Reported

Assessing the differences in characteristics of patients lost to follow-up at 2 years: results from the Quality Outcomes Database study on outcomes of surgery for grade I spondylolisthesis

Journal of Neurosurgery Spine ◽

10.3171/2019.12.spine191155 ◽

2020 ◽

Vol 33 (5) ◽

pp. 643-651

Author(s):

Erica F. Bisson ◽

Praveen V. Mummaneni ◽

John Knightly ◽

Mohammed Ali Alvi ◽

Anshit Goyal ◽

...

Keyword(s):

Degenerative Spondylolisthesis ◽

Leg Pain ◽

Quality Outcomes ◽

Loss To Follow Up ◽

Clinical Registries ◽

Pain Scores ◽

Patient Reported ◽

Lost To Follow Up ◽

OBJECTIVELoss to follow-up has been shown to bias outcomes assessment among studies utilizing clinical registries. Here, the authors analyzed patients enrolled in a national surgical registry and compared the baseline characteristics of patients captured with those lost to follow-up at 2 years.METHODSThe authors queried the Quality Outcomes Database for patients with grade I lumbar degenerative spondylolisthesis undergoing a surgical intervention between July 2014 and June 2016. Only those patients enrolled in a multisite study investigating the impact of fusion on clinical and patient-reported outcomes (PROs) among patients with grade I spondylolisthesis were evaluated.RESULTSOf the 608 patients enrolled in the study undergoing 1- or 2-level decompression (23.0%, n = 140) or 1-level fusion (77.0%, n = 468), 14.5% (n = 88) were lost to follow-up at 2 years. Patients who were lost to follow-up were more likely to be younger (59.6 ± 13.5 vs 62.6 ± 11.7 years, p = 0.031), be employed (unemployment rate: 53.3% [n = 277] for successful follow-up vs 40.9% [n = 36] for those lost to follow-up, p = 0.017), have anxiety (26.1% [n = 23] vs 16.3% [n = 85], p = 0.026), have higher back pain scores (7.4 ± 2.9 vs 6.6 ± 2.8, p = 0.010), have higher leg pain scores (7.4 ± 2.5 vs 6.4 ± 2.9, p = 0.003), have higher Oswestry Disability Index scores (50.8 ± 18.7 vs 46 ± 16.8, p = 0.018), and have lower EQ-5D scores (0.481 ± 0.2 vs 0.547 ± 0.2, p = 0.012) at baseline.CONCLUSIONSTo execute future, high-quality studies, it is important to identify patients undergoing surgery for spondylolisthesis who might be lost to follow-up. In a large, prospective registry, the authors found that those lost to follow-up were more likely to be younger, be employed, have anxiety disorder, and have worse PRO scores.

Abstract 078: Implications of Patient-Reported Treatment Satisfaction for Discontinuation of Rivaroxaban versus Warfarin in ROCKET-AF

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.078 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Fatima Rodriguez ◽

Leo Ungar ◽

Anne Hellkamp ◽

Richard C Becker ◽

Scott D Berkowitz ◽

...

Keyword(s):

Treatment Satisfaction ◽

Study Drug ◽

Drug Discontinuation ◽

Women Patients ◽

Double Blind ◽

Loss To Follow Up ◽

Patient Reported ◽

Study Drug Discontinuation

Background: Patient-reported outcomes and satisfaction are important in both trials and clinical practice and may be associated with treatment adherence. Methods: ROCKET-AF was a randomized, double-blind trial of rivaroxaban versus warfarin for prevention of thromboembolism in patients with atrial fibrillation. In a substudy, we compared treatment satisfaction scores: Anti-Clot Treatment Scale (ACTS) and Treatment Satisfaction Questionnaire for Medication version II (TSQM II). Patient-driven discontinuation included stopping study drugs due to withdrawal of consent, non-compliance, or loss to follow-up. Rates of discontinuation were calculated for participants above and below the median scores for each scale. Results: Of 14,264 patients in ROCKET AF, 1,181 (8.3%; median age 75 years; 34% women) patients completed both the ACTS and TSQM II questionnaires 4 weeks after starting the study drug. Over a median follow-up of 1.6 years, 450 premature study drug discontinuations occurred, 116 (26%) patient-driven. Patients less satisfied with treatment by the ACTS Benefits and Burdens and TSQM II scales had higher rates of study drug discontinuation ( Table ). Conclusions: Patient-reported satisfaction was lower in patients with study drug discontinuation, suggesting that collecting patient-reported outcomes early in clinical trials may guide interventions that improve adherence and clinical outcomes.

Are patient-reported outcomes useful in post-treatment follow-up care for women with early breast cancer? A scoping review

Patient Related Outcome Measures ◽

10.2147/prom.s195296 ◽

2019 ◽

Vol Volume 10 ◽

pp. 117-127 ◽

Cited By ~ 2

Author(s):

Cathrine Lundgaard Riis ◽

Troels Bechmann ◽

Pernille Tine Jensen ◽

Angela Coulter ◽

Karina Dahl Steffensen

Keyword(s):

Breast Cancer ◽

Early Breast Cancer ◽

Scoping Review ◽

Post Treatment ◽

Patient Reported ◽

Follow Up Care

Evaluating Survivorship Care Plans: Results of a Randomized, Clinical Trial of Patients With Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2011.36.8373 ◽

2011 ◽

Vol 29 (36) ◽

pp. 4755-4762 ◽

Cited By ~ 216

Author(s):

Eva Grunfeld ◽

Jim A. Julian ◽

Gregory Pond ◽

Elizabeth Maunsell ◽

Douglas Coyle ◽

...

Keyword(s):

Breast Cancer ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Event Scale ◽

Care Plans ◽

Patient Reported ◽

Secondary Outcomes ◽

Purpose An Institute of Medicine report recommends that patients with cancer receive a survivorship care plan (SCP). The trial objective was to determine if an SCP for breast cancer survivors improves patient-reported outcomes. Patients and Methods Women with early-stage breast cancer who completed primary treatment at least 3 months previously were eligible. Consenting patients were allocated within two strata: less than 24 months and ≥ 24 months since diagnosis. All patients were transferred to their own primary care physician (PCP) for follow-up. In addition to a discharge visit, the intervention group received an SCP, which was reviewed during a 30-minute educational session with a nurse, and their PCP received the SCP and guideline on follow-up. The primary outcome was cancer-related distress at 12 months, assessed by the Impact of Event Scale (IES). Secondary outcomes included quality of life, patient satisfaction, continuity/coordination of care, and health service measures. Results Overall, 408 survivors were enrolled through nine tertiary cancer centers. There were no differences between groups on cancer-related distress or on any of the patient-reported secondary outcomes, and there were no differences when the two strata were analyzed separately. More patients in the intervention than control group correctly identify their PCP as primarily responsible for follow-up (98.7% v 89.1%; difference, 9.6%; 95% CI, 3.9 to 15.9; P = .005). Conclusion The results do not support the hypothesis that SCPs are beneficial for improving patient-reported outcomes. Transferring follow-up to PCPs is considered an important strategy to meet the demand for scarce oncology resources. SCPs were no better than a standard discharge visit with the oncologist to facilitate transfer.

Do Patient Demographics and Patient Reported Outcomes Predict 12-Month Loss to Follow-Up after Spine Surgery?

The Spine Journal ◽

10.1016/j.spinee.2014.08.073 ◽

2014 ◽

Vol 14 (11) ◽

pp. S27

Author(s):

Scott L. Parker ◽

Saniya S. Godil ◽

Joseph S. Cheng ◽

Matthew J. McGirt ◽

Clinton J. Devin

Keyword(s):

Spine Surgery ◽

Loss To Follow Up ◽

Patient Demographics ◽

Patient Reported

Comment on: Improvement in patient-reported outcomes in Chinese adults after bariatric surgery: 1-year follow-up of a prospective cohort

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2020.06.013 ◽

2020 ◽

Vol 16 (10) ◽

pp. 1573-1574

Author(s):

Vamsi V. Alli

Keyword(s):

Bariatric Surgery ◽

Prospective Cohort ◽

Chinese Adults ◽

Patient Reported

THU0362 THE IMPACT OF A REFERRAL ALGORITHM FOR AXIAL SPONDYLOARTHRITIS: A FOUR MONTH FOLLOW-UP OF PATIENT REPORTED OUTCOMES

10.1136/annrheumdis-2019-eular.2027 ◽

2019 ◽

Author(s):

Maha Jamal Abdelkadir ◽

Amber Korver ◽

Martijn Kuijper ◽

Deirisa Lopes Barreto ◽

Cathelijne Appels ◽

...

Keyword(s):

Axial Spondyloarthritis ◽

Patient Reported ◽

Exploring the association between diabetes and breast cancer morbidity: considerations for quality care improvements among Latinas

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzz130 ◽

2020 ◽

Vol 32 (2) ◽

pp. 120-125

Author(s):

Kimlin Tam Ashing ◽

Lily Lai ◽

Eva Meyers ◽

Mayra Serrano ◽

Marshalee George

Keyword(s):

Breast Cancer ◽

Breast Cancer Survivors ◽

Care Delivery ◽

Quality Care ◽

Cancer Staging ◽

Patient Reported ◽

Follow Up Care ◽

Survivorship Care Planning ◽

Abstract Objective Cancer and diabetes are two severe chronic illnesses that often co-occur. In cancer patients, diabetes increases the risk for treatment complexities and mortality. Yet patient-reported outcomes with co-occurring chronic illness are understudied. Design This preliminary study investigated the association of diabetes with breast cancer-related morbidity among underserved Latina breast cancer survivors (BCS). Participants 137 Latina BCS were recruited from the California Cancer Registry and hospitals. Setting and Main Outcome Measure(s): BCS completed a self-administered mailed questionnaire assessing demographic and medical characteristics e.g. Type2 diabetes mellitus (T2DM). Results 28% Latina BCS reported co-occurring T2DM at twice the general population rate. Diabetes was most prevalent among Latina BCS > 65 years (43%). Latina BCS with diabetes were more likely to report advanced cancer staging at diagnosis (P = 0.036) and more lymphedema symptoms (P = 0.036). Results suggest non-significant but lower general health and greater physical functioning limitations among BCS with T2DM. Conclusions This study has relevance for precision population medicine by (i) consideration of routine diabetes screening in Latina BCS, (ii) underscoring attention to disease co-occurrence in treatment planning and care delivery and (iii) informing follow-up care and survivorship care planning e.g. patient self-management, oncology and primarily care surveillance and specialty care. Our findings can inform providers, survivors and caregivers about the impact of disease co-occurrence that influence clinically and patient responsive care for both initial treatment and long-term follow-up care to address disparities.