Ya-Lan Chang1,2, Shu-Chu Lee3, Chun-Ta Liao4, Chao-Hui Wang1,2, Yu-Fen Lin1, Shu-Ching Chen5,6,7. 1. Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 2. Department of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 3. Cancer Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 4. Departments of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. 5. School of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan. shuching@gw.cgust.edu.tw. 6. Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. shuching@gw.cgust.edu.tw. 7. Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. shuching@gw.cgust.edu.tw.
Abstract
PURPOSE: The aims of this study were to identify the factors and reasons impacting discordance with the treatment plan in head and neck cancer (HNC) patients and compare the differences between the concordance group and the discordance group. METHODS: This secondary analysis was conducted from population-based data from Taiwan collected from January 1, 2016, to June 30, 2018. Logistic regression analysis was used to identify the factors related to discordance with the treatment plan. RESULTS: We examined 1095 HNC patients, 12.1% of whom were discordant with treatment. Patients with advanced cancer stage, old age, and treatment plans of best supportive care (BSC) or surgery combined with radiation (RT), chemotherapy (CT), or chemoradiation (CCRT) were more likely to have discordance with their treatment plan. Of the 133 patients who were discordant with their treatment plan, the top reasons were as follows: "patients or their family considered patients' poor physical condition (chronic disease or unstable systemic disease), difficulty in enduring any condition likely to cause physical discomfort from disease treatment," "inconvenient transportation," and "disease progression." CONCLUSIONS: Patients' cancer stage, age, and types of treatment plans recommended significantly influenced discordance with treatment plan. Poor physical condition was the major reason for discordance with the treatment plan. Patients in the concordance group were significantly more likely than those in the discordance group to be younger than 65 years, have less advanced cancer stage, and be recommended to receive surgery rather than any other regimen. Multidisciplinary team care can help patients make positive decisions about treatment.
PURPOSE: The aims of this study were to identify the factors and reasons impacting discordance with the treatment plan in head and neck cancer (HNC) patients and compare the differences between the concordance group and the discordance group. METHODS: This secondary analysis was conducted from population-based data from Taiwan collected from January 1, 2016, to June 30, 2018. Logistic regression analysis was used to identify the factors related to discordance with the treatment plan. RESULTS: We examined 1095 HNC patients, 12.1% of whom were discordant with treatment. Patients with advanced cancer stage, old age, and treatment plans of best supportive care (BSC) or surgery combined with radiation (RT), chemotherapy (CT), or chemoradiation (CCRT) were more likely to have discordance with their treatment plan. Of the 133 patients who were discordant with their treatment plan, the top reasons were as follows: "patients or their family considered patients' poor physical condition (chronic disease or unstable systemic disease), difficulty in enduring any condition likely to cause physical discomfort from disease treatment," "inconvenient transportation," and "disease progression." CONCLUSIONS:Patients' cancer stage, age, and types of treatment plans recommended significantly influenced discordance with treatment plan. Poor physical condition was the major reason for discordance with the treatment plan. Patients in the concordance group were significantly more likely than those in the discordance group to be younger than 65 years, have less advanced cancer stage, and be recommended to receive surgery rather than any other regimen. Multidisciplinary team care can help patients make positive decisions about treatment.
Entities:
Keywords:
Head and neck cancer; Interdisciplinary health team; Medical care team; Patient noncompliance; Therapeutic compliance; Treatment adherence and compliance
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396