scholarly journals Quality of care indicators and their related outcomes: A population-based study in prostate cancer patients treated with radical prostatectomy

2014 ◽  
Vol 8 (7-8) ◽  
pp. 572 ◽  
Author(s):  
Colleen Webber ◽  
David Robert Siemens ◽  
Michael Brundage ◽  
Patti A Groome
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Quality Indicators ◽  
Hospital Volume ◽  
A Priori ◽  
Population Based ◽  
Follow Up Care ◽  
Cause Specific Survival

Introduction: We evaluated the validity of 8 quality of care indicators for prostate cancer patients treated curatively with radical prostatectomy (RP) by examining their association with indicator relevant outcomes.Methods: We conducted a population-based retrospective cohort study of 646 prostate cancer patients diagnosed between 1990 and 1998 who received RP within 6 months of diagnosis. Data were collected from treating charts and linked to registry and administrative data. Quality indicators included: hospital volume, pre-treatment risk assessment, consultation with a radiation oncologist, appropriate follow-up care, nerve-sparing surgery, units of blood transfused, surgical margin status, and pelvic lymph node dissection during RP. Indicator-relevant outcomes were selected a priori by clinical members of the research team. The associations between indicators and their relevant outcomes were analyzed using regression techniques, to control for potential confounders.Results: Of the quality indicators evaluated, only hospital volume was statistically significantly associated with the gradient in the expected direction. Patients treated in the lowest-volume hospitals (<1 RP/month) had lower cause-specific survival rates compared to patients treated in the highest-volume hospitals (≥7 RP/month) (HR=4.71 95%; CI 1.06-20.82). Completeness of follow-up care was associated with cause-specific survival but in the opposite direction to our hypothesis.Conclusion: The structural indicator of hospital volume was associated with cause-specific survival in accordance with our a priori hypothesis. Our negative findings for completeness of follow-up care call its validity into question. Issues of statistical power and measurement accuracy may have affected our validation of the remaining indicators underscoring the challenges in assessing the impact of accepted quality indicators.

Patients’ perspective on the quality of prostate cancer follow-up care.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 175-175
Author(s):  
Barbara M. Wollersheim ◽  
Henk G. van der Poel ◽  
Kristel M. van Asselt ◽  
Floris J. Pos ◽  
Emine Akdemir ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Promotion ◽  
Cancer Patients ◽  
Symptom Management ◽  
Background Information ◽  
Survivorship Care ◽  
Follow Up Care ◽  
Patients Perspective

175 Background: Information about prostate cancer patients’ perspective on the quality of their follow-up care in the hospital is important to optimize survivorship care. This study assessed the quality of prostate cancer follow-up care as experienced by cancer patients and its association with patients’ sociodemographic and clinical characteristics, and treatment-related symptom burden. Methods: We surveyed 385 (response rate, 100%) patients with localized prostate cancer participating in a randomized controlled trial comparing the (cost)effectiveness of specialist- versus primary care-based prostate cancer follow-up. For this study, we used baseline data that were collected during patients’ first follow-up visit at the hospital (2-34 weeks) after primary treatment (radical prostatectomy or radiotherapy) prior to randomization. We assessed patients’ ratings of the quality of follow-up care using the Assessment of Patient Experiences of Cancer Care survey. This survey consists of thirteen scales: getting needed care, timeliness of care, waiting time in physician’s office, information exchange, physician’s affective behavior, physicians’ knowledge about patients’ life, interaction with nurses, interaction with office staff, symptom management, symptom information provision, health promotion, coordination of care, and overall rating of care. Logistic regression analysis was used to identify factors associated with perceived quality of follow-up care. Results: Patients reported positive experiences with follow-up care for 10 of 13 scales, with mean scores ranging from 72 to 97 (on a 0-100 response scale). The three scales where patients reported suboptimal follow-up care were symptom management (mean score of 43), health promotion (mean score of 45), and physicians’ knowledge about patients’ life (mean score of 66). Overall, patients’ report of suboptimal quality of follow-up care was associated significantly with being more highly educated, not having a partner, being older, having multiple comorbidities, and experiencing symptoms (urinary, bowel, and hormonal symptoms). Conclusions: Prostate cancer patients were generally positive about their initial, hospital-based follow-up care after primary surgery or radiation. However, physicians’ knowledge about patients’ lives, symptom management, and health promotion was rated as suboptimal. The findings point to areas where prostate cancer survivorship care can be improved.

The prognostic significance of bone metastases and skeletal-related events (SREs) in prostate cancer survival: A population-based historical cohort study in Denmark (1999–2007)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5160-5160 ◽  
Author(s):  
J. P. Fryzek ◽  
K. Cetin ◽  
M. Nørgaard ◽  
A. Ø. Jensen ◽  
J. Jacobsen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Cancer Progression ◽  
Large Population ◽  
Prognostic Significance ◽  
Population Based ◽  
Short Term ◽  
Historical Cohort

5160 Background: Common among advanced prostate cancer patients, bone metastases indicate cancer progression and poor prognosis but few studies have quantified their influence on patient survival, particularly in the presence of subsequent skeletal-related complications. We therefore sought to examine this in a large population-based cohort of prostate cancer patients. Methods: Using data from the Danish National Patient Registry (covering all Danish hospitals), we studied 23,087 patients diagnosed with prostate cancer between 1999 and 2007, with follow-up through April 2008 (median follow-up: 2.2 years). We estimated the incidence of bone metastases following cancer diagnosis and the subsequent occurrence of SREs (radiation and surgery to the bone, fracture, spinal cord compression). We then computed and compared survival for three prostate cancer subgroups - no bone metastases, bone metastases, and bone metastases with SREs - using Kaplan-Meier and multivariate Cox proportional hazards models. Results: Across the study period, 14% (n = 3,261) of the prostate cancer patients developed bone metastases: 6.8% (n = 1,570) had bone metastases and no SRE and 7.3% (n = 1,691) had both bone metastases and at least one SRE (radiation to the bone was most frequent). One-year survival was lowest for prostate cancer patients with bone metastases and SREs (40%) compared to the groups with no bone metastases (87%) and with bone metastases but no SREs (47%). Similarly, after adjusting for age and the presence of comorbidities, short-term prognosis was poorest in patients with both bone metastases and SREs: compared to prostate cancer patients with no bone metastases, the 1-year mortality rate was 6.7 times greater for those with bone metastases and SREs (95% confidence interval (CI): 6.0–7.6) versus just 4.7 times higher in those with only bone metastases (95% CI: 4.3–5.2). Less than 1% of prostate cancer patients who developed bone metastases and suffered any SRE survived beyond five years. Conclusions: Although the presence of bone metastases confers a short-term prognosis in prostate cancer patients, survival is even poorer for patients who also experience skeletal-related complications. [Table: see text]

Incidence of skeletal-related events (SREs) among prostate cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16035-e16035
Author(s):  
Marianne Ulcickas Yood ◽  
Teresa Maria Zyczynski ◽  
Karen Wells ◽  
Deborah Casso ◽  
Benjamin Gutierrez ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Spinal Cord ◽  
Cancer Patients ◽  
Stage Iv ◽  
Cord Compression ◽  
Population Based ◽  
Tumor Registry ◽  
Ajcc Stage ◽  
Skeletal Related Events

e16035 Background: Skeletal related events (SREs) occur in men with prostate cancer and may result from both bone metastases and exposure to androgen deprivation therapy (ADT). The objective of this study was to quantify the incidence of SREs in patients with prostate cancer treated with ADT or orchiectomy in clinical practice. Methods: Prostate cancer patients served by Henry Ford Health System (HFHS) were identified via the HFHS tumor registry. Eligible patients were newly diagnosed with prostate cancer between 2004 and 2010 and treated with ADT or orchiectomy. Comprehensive population-based data were compiled using tumor registry with linkages to pharmacy, laboratory results, and healthcare encounter databases. SREs included spinal cord compression, surgery to bone, pathologic fracture and radiation to bone. Disease progression and metastases were identified by medical record review. Results: We identified 702 patients with prostate cancer and receipt of ADT or orchiectomy; 57.6% were >70 years of age and 43.7% were African American. 56.3% of patients were initially diagnosed at AJCC stage II, 9.8% at stage III, 22.1% at stage IV, and 11.8% had missing or unknown stage. A total of 93 patients (13.2%) had one or more SREs: radiation to bone (8.5%) and spinal cord compression (3.1%) were the most common SREs. We then limited the cohort to patients initially diagnosed with or progressing to AJCC stage IV prostate cancer (N=207). Among this group, 47.8% were >70 years of age. The mean time from stage IV diagnosis to end of follow-up was 35.6 months. In this subgroup, 16.4% of patients were initially diagnosed at AJCC stage II, 8.2% at stage III, 69.6% at stage IV, and 5.8% had missing or unknown stage. 57 patients (27.5%) had one or more SREs. Conclusions: Some clinical trials have found 36-41% of high-risk metastatic prostate cancer patients developed SREs during 3 years of follow-up. In this population-based cohort of patients with prostate cancer receiving ADT or orchiectomy and treated in real-world clinical practice, we found the incidence of SREs to be lower than what has been reported in clinical trials. Additional analyses exploring the incidence of SREs in patients diagnosed with metastatic castrate resistant prostate cancer will be presented.

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