Servicio de Oncología Médica, Hospital Universitario Puerta del Mar, Avda. Ana de Viya 21, Cádiz, Spain.
Eur J Cancer. 2012 Dec;48(18):3328-34. doi: 10.1016/j.ejca.2012.04.024. Epub 2012 Jun 8.
The authors analyse the effect of chemotherapy on the use of additional health-care resources and report the clinical and demographic factors associated with such use.
In women with breast cancer, eligible to receive first-line (neo)-adjuvant or palliative chemotherapy, consultations with health-care practitioners (general practitioners [GPs] and specialists) and admissions to emergency department and to hospital were prospectively recorded. Differences were studied according to these clinical and demographic variables: age, tumour stage, performance status, weight, height, body mass index, surgery type, chemotherapy type, number of courses, comorbidity, marital status, educational level, social status and occupational status.
Among 268 patients, 124 (42.2%) required one or more non-protocol health-care encounters. 180 visits were generated (GP 23.3%, specialist 35.5%, emergency department admission 21.1%, hospital admission 8.3%, others 3.3% and more than one resource 8.3%). Of total consultations 150 (83.3%) were chemotherapy-related. The number of visits was higher in the first courses. Fever and infection were the most frequent reasons for consultation in all resources. The dependent variable: 'need for non-protocol health-care encounter in any course' was statistically associated with age (p=0.002) and marital status (p=0.021); no association was found with other variables. In multivariate analysis, age (p=0.001) and marital status (p=0.009) remained statistically significant. Younger and married patients consumed less extra health resources.
Many patients receiving chemotherapy consume health-care resources in addition to their routine visits, usually treatment-related. Patients consult less in the later courses. Older and unmarried women in particular need extra care during chemotherapy.
作者分析了化疗对额外医疗资源使用的影响，并报告了与这种使用相关的临床和人口统计学因素。
在有资格接受一线（新）辅助或姑息化疗的乳腺癌女性中，前瞻性地记录了与医疗保健从业者（全科医生[GP]和专家）的咨询以及到急诊部和住院的就诊情况。根据这些临床和人口统计学变量研究了差异：年龄、肿瘤分期、功能状态、体重、身高、体重指数、手术类型、化疗类型、疗程数、合并症、婚姻状况、教育水平、社会地位和职业地位。
在 268 名患者中，有 124 名（42.2%）需要一次或多次非方案的医疗保健就诊。共产生 180 次就诊（GP 23.3%，专家 35.5%，急诊部就诊 21.1%，住院部就诊 8.3%，其他 3.3%，并使用了多种资源 8.3%）。总咨询中有 150 次（83.3%）与化疗相关。在第一疗程中就诊次数较多。发烧和感染是所有资源中最常见的咨询原因。因变量：“任何疗程中需要非方案医疗保健就诊”与年龄（p=0.002）和婚姻状况（p=0.021）有统计学关联；与其他变量无关联。在多变量分析中，年龄（p=0.001）和婚姻状况（p=0.009）仍然具有统计学意义。年轻和已婚患者消耗的额外医疗资源较少。
许多接受化疗的患者除了常规就诊外还会额外使用医疗资源，通常与治疗相关。患者在后续疗程中就诊较少。特别是年龄较大和未婚的女性在化疗期间需要额外的护理。
