Introduction
Patients and methods
Design and setting
Participants and data collection
Data analysis
Patients | Ref. pop. |
p value | |
---|---|---|---|
General practice, n (%) | 0.926a
| ||
Groningen | 64 (34.6) | 182 (33.2) | |
Hoogeveen | 55 (29.7) | 170 (31.0) | |
Sappemeer | 66 (35.7) | 196 (35.8) | |
Age at diagnosis, median (range), years | 56.2 (27.4–96.0) | 55.8 (26.8–94.8) | 0.854b
|
T stage, n (%) | |||
Tis | 15 (8.6) | ||
T1 | 83 (47.7) | ||
T2/T3/T4 | 76 (43.7) | ||
Unknown | 11 | ||
N stage, n (%) | |||
N0 | 112 (62.6) | ||
N+ | 67 (37.4) | ||
Unknown | 6 | ||
Surgery, n (%) | |||
None | 3 (1.6) | ||
Lumpectomy | 2 (1.1) | ||
Lumpectomy + radiation therapy | 93 (50.3) | ||
Mastectomyc
| 61 (33.0) | ||
Mastectomyc + radiation therapy | 26 (14.1) | ||
Systemic treatment, n (%) | |||
None | 85 (45.9) | ||
Chemotherapy | 20 (10.8) | ||
Endocrine therapy | 36 (19.5) | ||
Chemotherapy + endocrine therapy | 44 (23.8) | ||
Early endpoints in year since diagnosis, n (%) | |||
Recurrent breast cancer | 1 (0.5) | ||
Departure | 3 (1.6) | 10 (1.8) | |
Death | 1 (0.5) | 11 (2.0) | |
Other | 0 (0.0) | 3 (0.5) | |
Observation time, median (range), days | |||
Period before diagnosis | 365.0 (4.0–366.0) | 365.0 (4.0–366.0) | 0.716b
|
Period since diagnosis | 365.0 (33.0–366.0) | 365.0 (10.0–366.0) | 0.922b
|
Annual health care utilisation | ||||
---|---|---|---|---|
Before diagnosis | Since diagnosis | |||
Patients | Ref. pop. | Patients | Ref. pop. | |
Face-to-face contacts | ||||
Median (range) | 2.2 (0.0–18.7) | 2.0 (0.0–32.0) | 6.0 (0.0–46.0) | 3.0 (0.0–31.7) |
Women with any face-to-face contact, n (%) | 149 (80.5) | 428 (78.1) | 184 (99.5) | 428 (78.1) |
Drug prescriptions | ||||
Median (range) | 6.0 (0.0–220.0) | 6.0 (0.0–111.0) | 11.0 (0.0–212.0) | 7.0 (0–127.0) |
Women with any drug prescription, n (%) | 156 (84.3) | 437 (79.7) | 170 (91.9) | 447 (81.6) |
Referrals | ||||
Median (range) | 0.0 (0.0–13.8) | 0.0 (0.0–6.9) | 1.0 (0.0–11.1) | 0.0 (0.0–7.9) |
Women with any referral, n (%) | 53 (28.6) | 157 (28.6) | 165 (89.2) | 164 (29.9) |
Since diagnosis | ||
---|---|---|
Patients | Ref. pop. | |
Women with any face-to-face contact by ICPC chapter/code, n (%) | ||
General and unspecified (A)*** | 62 (33.5) | 78 (14.2) |
Blood, blood-forming organs and immune mechanism (B)* | 13 (7.0) | 16 (2.9) |
Digestive (D) | 40 (21.6) | 92 (16.8) |
Eye (F) | 10 (5.4) | 34 (6.2) |
Ear (H) | 12 (6.5) | 51 (9.3) |
Cardiovascular (K) | 40 (21.6) | 142 (25.9) |
Musculoskeletal (L) | 69 (37.3) | 188 (34.3) |
Neurological (N) | 20 (10.8) | 60 (10.9) |
Psychological (P)* | 34 (18.4) | 64 (11.7) |
Respiratory (R) | 54 (29.2) | 121 (22.1) |
Skin (S)** | 65 (35.1) | 135 (24.6) |
Endocrine, metabolic and nutritional (T) | 18 (9.7) | 48 (8.8) |
Urological (U) | 13 (7.0) | 34 (6.2) |
Pregnancy, childbearing and family planning (W)a
| 1 (0.5) | 12 (2.2) |
Female genital (X)*** | 177 (95.7) | 99 (18.1) |
Breast symptoms (X18–X21)*** | 131 (70.8) | 11 (2.0) |
Breast cancer (X76)*** | 157 (84.9) | 0 (0.0) |
Social problems (Z) | 12 (6.5) | 37 (6.8) |
Women with any drug prescription by ATC chapter/code, n (%) | ||
Alimentary tract and metabolism (A)*** | 94 (50.8) | 165 (30.1) |
Drugs for functional gastrointestinal disorders (A03)*** | 34 (18.4) | 16 (2.9) |
Propulsives (A03F)*** | 31 (16.8) | 10 (1.8) |
Antiemetics and antinauseants (A04)*** | 24 (13.0) | 2 (0.4) |
Serotonin (5-HT3) antagonists (A04AA)*** | 24 (13.0) | 2 (0.4) |
Laxatives (A06)*** | 35 (18.9) | 41 (7.5) |
Osmotically acting laxatives (A06AD)*** | 27 (14.6) | 28 (5.1) |
Antidiarrheals, intestinal anti-inflammatory/infective agents (A07)*** | 16 (8.6) | 9 (1.6) |
Blood and blood-forming organs (B) | 31 (16.8) | 77 (14.1) |
Cardiovascular system (C) | 72 (38.9) | 206 (37.6) |
Dermatologicals (D)* | 55 (29.7) | 114 (20.8) |
Antibiotics and chemotherapeutics for dermatological use (D06)** | 12 (6.5) | 13 (2.4) |
Genito-urinary system and sex hormones (G)** | 17 (9.2) | 94 (17.2) |
Sex hormones and modulators of the genital system (G03)** | 9 (4.9) | 79 (14.4) |
Hormonal contraceptives for systemic use (G03A)** | 3 (1.6) | 43 (7.8) |
Systemic hormonal preparations, excl. sex hormones and insulins (H)* | 32 (17.3) | 60 (10.9) |
Corticosteroids for systemic use (H02)* | 22 (11.9) | 34 (6.2) |
Corticosteroids for systemic use, plain (H02A)* | 22 (11.9) | 34 (6.2) |
Anti-infectives for systemic use (J)** | 98 (53.0) | 211 (38.5) |
Antibacterials for systemic use (J01)*** | 77 (41.6) | 134 (24.5) |
Beta-lactam antibacterials, penicillins (J01C)*** | 35 (18.9) | 45 (8.2) |
Antineoplastic and immunomodulating agents (L)*** | 66 (35.7) | 6 (1.1) |
Endocrine therapy (L02)*** | 65 (35.1) | 0 (0.0) |
Hormone antagonists and related agents (L02B)*** | 64 (34.6) | 0 (0.0) |
Anti-estrogens (L02BA)*** | 53 (28.6) | 0 (0.0) |
Tamoxifen (L02BA01)*** | 53 (28.6) | 0 (0.0) |
Musculoskeletal system (M) | 50 (27.0) | 145 (26.5) |
Nervous system (N)*** | 96 (51.9) | 203 (37.0) |
Analgesics (N02)** | 47 (25.4) | 80 (14.6) |
Other analgesics and antipyretics (N02B)** | 31 (16.8) | 50 (9.1) |
Anilides (N02BE)*** | 31 (16.8) | 45 (8.2) |
Psycholeptics (N05)*** | 81 (43.8) | 133 (24.3) |
Anxiolytics (N05B)*** | 62 (33.5) | 90 (16.4) |
Benzodiazepine derivatives (N05BA)*** | 61 (33.0) | 88 (16.1) |
Hypnotics and sedatives (N05C)*** | 37 (20.0) | 55 (10.0) |
Benzodiazepine derivatives (N05CD)*** | 37 (20.0) | 53 (9.7) |
Antiparasitic products, insecticides and repellents (P)a
| 0 (0.0) | 0 (0.0) |
Respiratory system (R) | 54 (29.2) | 125 (22.8) |
Sensory organs (S) | 26 (14.1) | 68 (12.4) |
Various (V)a
| 0 (0.0) | 2 (0.4) |
Univariate | Multivariate | |||
---|---|---|---|---|
≤ Median | > Median | OR (CI) | OR (CI) | |
Outcome: annual face-to-face contact rate since diagnosis |
n = 100 |
n = 85 | ||
Face-to-face contact rate before diagnosis, n (%) | ||||
≤ Median | 61 (61.0) | 32 (37.6) | 1 | |
> Median | 39 (39.0) | 53 (62.4) | 2.59 (1.43–4.70)** | |
General practice, n (%) | ||||
Groningen | 41 (41.0) | 23 (27.1) | 1 | |
Hoogeveen | 27 (27.0) | 28 (32.9) | 1.85 (0.89–3.86) | |
Sappemeer | 32 (32.0) | 34 (40.0) | 1.89 (0.94–3.82) | |
Age at diagnosis, n (%) | ||||
≤ Median | 55 (55.0) | 38 (44.7) | 1 | |
> Median | 45 (45.0) | 47 (55.3) | 1.51 (0.85–2.70) | |
T stage, n (%) | ||||
Tis/T1 | 61 (63.5) | 37 (47.2) | 1 | |
T2/T3/T4 | 35 (36.5) | 41 (52.6) | 1.93 (1.05–3.55)* | |
N stage, n (%) | ||||
N0 | 63 (64.3) | 49 (60.5) | 1 | |
N+ | 35 (35.7) | 32 (39.5) | 1.18 (0.64–2.16) | |
Surgery, n (%) | ||||
Lumpectomya
| 58 (59.2) | 37 (44.0) | 1 | |
Mastectomyb
| 40 (40.8) | 47 (56.0) | 1.86 (1.03–3.37)* | |
Chemotherapy, n (%) | ||||
No | 65 (65.0) | 56 (65.9) | 1 | |
Yes | 35 (35.0) | 29 (34.1) | 0.96 (0.52–1.77) | |
Endocrine therapy, n (%) | ||||
No | 65 (65.0) | 40 (47.1) | 1 | |
Yes | 35 (35.0) | 45 (52.9) | 2.09 (1.16–3.78)* | |
Outcome: annual drug prescription rate since diagnosis |
n = 95 |
n = 90 | ||
Drug prescription rate before diagnosis, n (%)* | ||||
≤ Median | 80 (84.2) | 17 (18.9) | 1 | 1 |
> Median | 15 (15.8) | 73 (81.1) | 22.90 (10.67–49.14)*** | 23.23 (10.14–53.22)*** |
General practice, n (%)* | ||||
Groningen | 41 (43.2) | 23 (25.6) | 1 | 1 |
Hoogeveen | 21 (22.1) | 34 (37.8) | 2.89 (1.37–6.09)** | 4.09 (1.49–11.24)** |
Sappemeer | 33 (34.7) | 33 (36.7) | 1.78 (0.88–3.60) | 1.56 (0.60–4.04) |
Age at diagnosis, n (%)* | ||||
≤ Median | 59 (62.1) | 34 (37.8) | 1 | 1 |
> Median | 36 (37.9) | 56 (62.2) | 2.70 (1.49–4.89)** | 1.50 (0.66–3.40) |
T stage, n (%) | ||||
Tis/T1 | 53 (57.0) | 45 (55.6) | 1 | |
T2/T3/T4 | 40 (43.0) | 36 (44.4) | 1.06 (0.58–1.93) | |
N stage, n (%) | ||||
N0 | 58 (61.7) | 54 (63.5) | 1 | |
N+ | 36 (38.3) | 31 (36.5) | 0.92 (0.50–1.70) | |
Surgery, n (%) | ||||
Lumpectomya
| 52 (55.3) | 43 (48.9) | 1 | |
Mastectomyb
| 42 (44.7) | 45 (51.1) | 1.36 (0.76–2.44) | |
Chemotherapy, n (%) | ||||
No | 58 (61.1) | 63 (70.0) | 1 | |
Yes | 37 (38.9) | 27 (30.0) | 0.76 (0.36–1.24) | |
Endocrine therapy, n (%) | ||||
No | 59 (62.1) | 46 (51.1) | 1 | |
Yes | 36 (37.9) | 44 (48.9) | 1.57 (0.87–2.81) |