Implementation of Value Based Breast Cancer Care

Egdom, Laurentine S. E. van; Lagendijk, M.; Kemp, Melissa; Dam, Johan Hygum; Mureau, Marc A.M.; Hazelzet, Jan A.; Koppert, Linetta B.

doi:10.1016/j.ejso.2019.01.007

Cited by 60 publications

(84 citation statements)

References 32 publications

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“…For the development of such a set, out organization works according to a so called blueprint which is adapted to the specific situation of a disease team. This way of working is described in detail elsewhere . In brief, a disease team is formed consisting of the most important disciplines involved in the treatment, in this case the departments of internal medicine, gynaecology and cardiology.…”

Section: Methodsmentioning

confidence: 99%

“…For women with Turner syndrome, navigating the complex healthcare pathway involving many specialties can be daunting. Therefore, this pathway was redesigned analogous to the breast cancer care pathway described earlier (Ref ). A critical step within VBHC is defining an outcomes set, and this was done with the described multidisciplinary team.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, the importance of psychometrically sound disease‐specific tools has been stressed in other chronic illnesses, where more generic tools often fail to capture loss of quality of life on disease‐specific domains . In this study, we describe the development and first results of a set of clinician and patient‐reported outcome set in Turner syndrome as part of the value‐based healthcare programmes in our hospital . We aim to provide a comprehensive evaluation of HR‐QoL and different domains of psychosocial functioning in women with TS in order to identify individual and disease‐specific targets for effective improvement of their HR‐QoL.…”

Section: Introductionmentioning

confidence: 99%

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A value‐based healthcare approach: Health‐related quality of life and psychosocial functioning in women with Turner syndrome

Hoven

Bons

Dykgraaf

et al. 2020

Clinical Endocrinology

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Objective: As part of the value-based healthcare programme in our hospital, a set of patient-reported outcome measures was developed together with patients and implemented in the dedicated Turner Syndrome (TS) outpatient clinic. This study aims to investigate different aspects of health-related quality of life (HR-QoL) and psychosocial functioning in women with TS in order to establish new possible targets for therapy.Design/Participants: A comprehensive set of questionnaires (EQ-5D, PSS-10, CIS-20, Ferti-QoL, FSFI) was developed and used to capture different aspects of HR-QoL and psychosocial functioning in a large cohort of adult women with Turner syndrome. All consecutive women, ≥18 years, who visited the outpatient clinic of our tertiary centre were eligible for inclusion. Results:Of the eligible 201 women who were invited to participate, 177 women (age 34 ± 12 years, mean ± SD) completed at least one of the validated questionnaires (88%). Women with TS reported a lower health-related quality of life (EQ-5D: 0.857 vs 0.892, P = .003), perceived more stress (PSS-10:14.7 vs 13.3; P = .012) and experienced increased fatigue (CIS-20: P < .001) compared to the general Dutch population. A relationship between noncardiac comorbidities (eg diabetes, orthopaedic complaints) and HR-QoL was found (R = .508). Conclusions:We showed that TS women suffer from impaired HR-QoL, more perceived stress and increased fatigue compared to healthy controls. A relationship between noncardiac comorbidities and HR-QoL was found. Especially perceived stress and increased fatigue can be considered targets for improvement of HR-QoL in TS women. | 435van den HOven et al.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A value‐based healthcare approach: Health‐related quality of life and psychosocial functioning in women with Turner syndrome

Hoven

Bons

Dykgraaf

et al. 2020

Clinical Endocrinology

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“…At Erasmus University Medical Center (Erasmus MC), Rotterdam, the Netherlands, a working group of FH experts was established consisting of: an internist vascular medicine specialized in lipid disorders, nurse practitioner, 2 specialized FH nurses, and an FH patient representing the Dutch national FH patient support group "Harteraad". The VBHC expert team of Erasmus MC, including a health psychologist, guided the working group through an institutional, standardized process [13].…”

Section: Working Groupmentioning

confidence: 99%

“…The development of FH specific patient outcome measures was structured according the blueprint previously described [13]. The working group convened for 5 sessions between November 2015 and March 2016.…”

Section: Development Of the Outcome Setmentioning

confidence: 99%

The development and first results of a health-related outcomes set in familial hypercholesterolemia (FH) patients: Knowledge is health

et al. 2020

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A health-related outcomes set has been developed for familial hypercholesterolemia (FH) patients. • This set contained both outcomes defined by health care professionals as patient-related outcomes (PROMS). • The response rate of the PROMS was 81.4%, implicating high acceptance.• Sufficient knowledge of a patient was associated with better health-outcomes. A R T I C L E I N F O Keywords:Familial hypercholesterolemia Value-based health care Patient-reported outcome measures Prevention Cardiovascular disease A B S T R A C TBackground and aims: Familial hypercholesterolemia (FH) is the most common hereditary lipid disorder requiring life-long treatment to prevent cardiovascular disease. A recent concept in healthcare is not only to focus on outcomes defined by healthcare professionals, but also take Patient-Reported Outcomes Measures (PROMs) into account. The aim of this study is (1) to describe the development and first results of a health-related outcomes set including PROMs for FH patients and (2) investigate the influence of patient knowledge on healthrelated outcomes. Methods: A multidisciplinary group of FH experts, in collaboration with a sounding board of FH patients (n = 166), developed a health-related outcomes set containing the domains: medication adherence (MARS-5), smoking, self-efficacy and self-management, quality of life (QOL) (EQ-5D-5L), reported adverse drug reactions, lipid outcome measures, and FH and cardiovascular risk factor knowledge. Knowledge scores ranged from 0 to 10. Two groups were created: Insufficient knowledge (INSUF) (< 7.5), and Sufficient knowledge (SUF) (≥7.5). Results: The response rate of the questionnaires was 81.4% (n = 429), implicating acceptance of PROMs. In general, FH patients showed good knowledge, high QOL and were adherent to medication. However, the INSUF group had higher triglycerides levels (1.0 vs 0.9, p < 0.05), lower QOL (0.89 [0.79, 1.00] vs 0.89 [0.85, 1.00], p < 0.05), were more often smokers (14% vs 7%, p < 0.05) and reported more adverse drug reactions (62% vs. 49%, p < 0.05). Conclusions: A health-related outcomes set for FH patients, including PROMs, has been developed, which shows that insufficient knowledge of FH is negatively related to health outcomes. Improving patients' knowledge of FH may lead to better health.

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Health utility values of breast cancer treatments and the impact of varying quality of life assumptions on cost‐effectiveness

Kregting,

Vrancken Peeters,

Clarijs

et al. 2024

Intl Journal of Cancer

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In breast cancer research, utility assumptions are outdated and inconsistent which may affect the results of quality adjusted life year (QALY) calculations and thereby cost‐effectiveness analyses (CEAs). Four hundred sixty four female patients with breast cancer treated at Erasmus MC, the Netherlands, completed EQ‐5D‐5L questionnaires from diagnosis throughout their treatment. Average utilities were calculated stratified by age and treatment. These utilities were applied in CEAs analysing 920 breast cancer screening policies differing in eligible ages and screening interval simulated by the MISCAN‐Breast microsimulation model, using a willingness‐to‐pay threshold of €20,000. The CEAs included varying sets on normative, breast cancer treatment and screening and follow‐up utilities. Efficiency frontiers were compared to assess the impact of the utility sets. The calculated average patient utilities were reduced at breast cancer diagnosis and 6 months after surgery and increased toward normative utilities 12 months after surgery. When using normative utility values of 1 in CEAs, QALYs were overestimated compared to using average gender and age‐specific values. Only small differences in QALYs gained were seen when varying treatment utilities in CEAs. The CEAs varying screening and follow‐up utilities showed only small changes in QALYs gained and the efficiency frontier. Throughout all variations in utility sets, the optimal strategy remained robust; biennial for ages 40–76 years and occasionally biennial 40–74 years. In sum, we recommend to use gender and age stratified normative utilities in CEAs, and patient‐based breast cancer utilities stratified by age and treatment or disease stage. Furthermore, despite varying utilities, the optimal screening scenario seems very robust.

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Implementation of Value Based Breast Cancer Care

Cited by 60 publications

References 32 publications

A value‐based healthcare approach: Health‐related quality of life and psychosocial functioning in women with Turner syndrome

A value‐based healthcare approach: Health‐related quality of life and psychosocial functioning in women with Turner syndrome

The development and first results of a health-related outcomes set in familial hypercholesterolemia (FH) patients: Knowledge is health

Health utility values of breast cancer treatments and the impact of varying quality of life assumptions on cost‐effectiveness

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