| アブストラクト | PURPOSE: Overlooking other medical conditions during cancer treatment and follow-up could result in excess morbidity and mortality, thereby undermining gains associated with early detection and improved treatment of cancer. We compared the quality of care for diabetes patients subsequently diagnosed with breast, colorectal, or prostate cancer to matched, diabetic non-cancer controls. METHODS: Longitudinal cohort study using primary care records from the Clinical Practice Research Datalink, United Kingdom. Patients with pre-existing diabetes were followed for up to 5 years after cancer diagnosis, or after an assigned index date (non-cancer controls). Quality of diabetes care was estimated based on Quality and Outcomes Framework indicators. Mixed effects logistic regression analyses were used to compare the unadjusted and adjusted odds of meeting quality measures between cancer patients and controls, overall and stratified by type of cancer. RESULTS: 3382 cancer patients and 11,135 controls contributed 44,507 person-years of follow-up. In adjusted analyses, cancer patients were less likely to meet five of 14 quality measures, including: total cholesterol </= 5 mmol/L (odds ratio [OR] = 0.82; 95% confidence interval [CI], 0.75-0.90); glycosylated hemoglobin </= 59 mmol/mol (adjusted OR = 0.77; 95% CI, 0.70-0.85); and albumin creatinine ratio testing (adjusted OR = 0.83; 95% CI, 0.75-0.91). However, cancer patients were as likely as their matched controls to meet quality measures for other diabetes services, including retinal screening, foot examination, and dietary review. CONCLUSIONS: Although in the short-term, cancer patients were less likely to achieve target thresholds for cholesterol and HbA1c, they continued to receive high-quality diabetes primary care throughout 5 years post diagnosis. IMPLICATIONS FOR CANCER SURVIVORS: These findings are important for cancer survivors with pre-existing diabetes because they indicate that high-quality diabetes care is maintained throughout the continuum of cancer diagnosis, treatment, and follow-up. |
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| ジャーナル名 | Journal of cancer survivorship : research and practice |
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| Pubmed追加日 | 2018/10/7 |
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| 投稿者 | Griffiths, Robert I; McFadden, Emily C; Stevens, Richard J; Valderas, Jose M; Lavery, Bernadette A; Khan, Nada F; Keating, Nancy L; Bankhead, Clare R |
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| 組織名 | Nuffield Department of Primary Care Health Sciences, University of Oxford,;Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road,;Oxford, 0X2 6GG, UK. robert.griffiths@conted.ox.ac.uk.;Division of General Internal Medicine, Johns Hopkins University School of;Medicine, Baltimore, 21205, USA. robert.griffiths@conted.ox.ac.uk.;Oxford, 0X2 6GG, UK.;Health Services & Policy Research Group and Exeter Collaboration for Primary Care;(APEx), University of Exeter, Exeter, EX4 4SB, UK.;Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK.;Royal Liverpool University Hospital, Liverpool, L7 8XP, UK.;Department of Health Care Policy, Harvard Medical School, Boston, 02115, USA.;Division of General Internal Medicine and Primary Care, Brigham and Women's;Hospital, Boston, 02115, USA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30291561/ |
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