TY - JOUR
T1 - Breast Cancer Survivorship Care Variations Between Adjuvant Chemotherapy Regimens
AU - Leal, Alexis D.
AU - Van Houten, Holly
AU - Sangaralingham, Lindsey
AU - Freedman, Rachel A.
AU - Jemal, Ahmedin
AU - Neuman, Heather B.
AU - Haddad, Tufia C.
AU - Mutter, Robert W.
AU - Keegan, Theresa H.M.
AU - Mougalian, Sarah S.
AU - Loprinzi, Charles L.
AU - Gross, Cary P.
AU - Shah, Nilay
AU - Ruddy, Kathryn J.
N1 - Funding Information:
Kathryn J. Ruddy was supported by a National Institutes of Health (NIH) training grant under the Center for Translational Science Activities (CTSA) Grant Program from the National Center for Advancing Translational Sciences (UL1 TR000135, KL2TR000136-09). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of NIH. Lindsey Sangaralingham was supported by a 2016 National Comprehensive Cancer Network Foundation Young Investigator Award (PI: Ruddy).
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/8
Y1 - 2018/8
N2 - Administrative claims data from a commercial insurance database were analyzed to evaluate differences in rates of outpatient office visits during the year after completion of 4 chemotherapy regimens for early stage breast cancer. Combined anthracycline/taxane was associated with more frequent office visits than docetaxel-cyclophosphamide or doxorubicin-cyclophosphamide, possibly because of greater long-term toxicities. Primary care visits were infrequent. Background: Treatment-related toxicity can vary substantially between chemotherapy regimens. In this study we evaluated the frequency of outpatient office visits among a cohort of early stage breast cancer survivors after completion of 4 different adjuvant chemotherapy regimens to better understand how differences in toxicities between regimens might affect health care use. Materials and Methods: We analyzed administrative claims data from a US commercial insurance database (OptumLabs) to identify women who received adjuvant doxorubicin/cyclophosphamide (AC), AC followed or preceded by docetaxel or paclitaxel (AC-T), AC concurrent with docetaxel or paclitaxel (TAC), or docetaxel/cyclophosphamide (TC) between 2008 and 2014. We compared mean numbers of visits per patient (adjusted for age, race/ethnicity, region, year, surgery type, radiation, chronic conditions, and previous hospitalizations) across the different regimens (TC = reference) for 12 months, starting 4 months after the end of chemotherapy. Results: In 6247 eligible patients, the mean adjusted number of outpatient visits per patient was significantly higher in patients who received AC-T (8.1) or TAC (7.3) than TC (6.5) or AC (6.0; P <.001 for comparisons of AC-T and TAC with TC), primarily because of differences in Medical Oncology visits. Approximately 40% did not see a primary care provider at all during this time frame. Conclusions: AC-T and TAC are associated with more subsequent outpatient visits than TC. Visits to primary care providers are infrequent during the year after completion of chemotherapy.
AB - Administrative claims data from a commercial insurance database were analyzed to evaluate differences in rates of outpatient office visits during the year after completion of 4 chemotherapy regimens for early stage breast cancer. Combined anthracycline/taxane was associated with more frequent office visits than docetaxel-cyclophosphamide or doxorubicin-cyclophosphamide, possibly because of greater long-term toxicities. Primary care visits were infrequent. Background: Treatment-related toxicity can vary substantially between chemotherapy regimens. In this study we evaluated the frequency of outpatient office visits among a cohort of early stage breast cancer survivors after completion of 4 different adjuvant chemotherapy regimens to better understand how differences in toxicities between regimens might affect health care use. Materials and Methods: We analyzed administrative claims data from a US commercial insurance database (OptumLabs) to identify women who received adjuvant doxorubicin/cyclophosphamide (AC), AC followed or preceded by docetaxel or paclitaxel (AC-T), AC concurrent with docetaxel or paclitaxel (TAC), or docetaxel/cyclophosphamide (TC) between 2008 and 2014. We compared mean numbers of visits per patient (adjusted for age, race/ethnicity, region, year, surgery type, radiation, chronic conditions, and previous hospitalizations) across the different regimens (TC = reference) for 12 months, starting 4 months after the end of chemotherapy. Results: In 6247 eligible patients, the mean adjusted number of outpatient visits per patient was significantly higher in patients who received AC-T (8.1) or TAC (7.3) than TC (6.5) or AC (6.0; P <.001 for comparisons of AC-T and TAC with TC), primarily because of differences in Medical Oncology visits. Approximately 40% did not see a primary care provider at all during this time frame. Conclusions: AC-T and TAC are associated with more subsequent outpatient visits than TC. Visits to primary care providers are infrequent during the year after completion of chemotherapy.
KW - Breast neoplasms
KW - Follow-up
KW - Health care use
KW - Outpatient
KW - Toxicity
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U2 - 10.1016/j.clbc.2017.09.011
DO - 10.1016/j.clbc.2017.09.011
M3 - Article
C2 - 29054689
AN - SCOPUS:85031697503
SN - 1526-8209
VL - 18
SP - e513-e520
JO - Clinical breast cancer
JF - Clinical breast cancer
IS - 4
ER -