Colorectal Cancer, Health Care Utilization, Treatment Compliance
Conditions
Brief summary
Observational study to assess barriers for colorectal cancer treatment compliance in India, including quantitative assessment of catastrophic expenditure incidence and qualitative assessment of financial and non-financial barriers.
Detailed description
Objective: To identify a vulnerable group of colorectal cancer patients in India who cannot afford or are unable to comply with a treatment plan for colorectal cancer. Aims: 1. To identify the proportion of CRC patients suffering catastrophic expenditure due to out-of-pocket payments for cancer treatment. 2. To determine the proportion of patients who are unable to comply with the treatment plan for CRC, at 6 weeks, 3 months and 6 months after diagnosis. 3. To identify barriers and solutions to CRC treatment compliance. Design: A mixed-methods study comprising quantitative pilot data from 3 tertiary cancer centres and qualitative work from interviews with patients and healthcare professionals. Participants: Patients diagnosed with primary colorectal cancer. Outcomes: Primary outcome: • Incidence of catastrophic expenditure due to out-of-pocket payments for cancer care at 3 timepoints: 6 weeks, 3 months and 6 months after CRC diagnosis. Secondary outcomes: * Compliance to the initial treatment plan at three timepoints: 6 weeks, 3 months and 6 months after CRC diagnosis. * Patients and healthcare professionals perspectives on patient compliance to CRC treatment. * Identify the 5 main drivers (items charged to the patient) of CRC treatment cost. * Colorectal cancer stage at the time of diagnosis.
Interventions
None listed
Sponsors
NIHR Research Unit on Global Surgery
University of Birmingham
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18+ years old. AND * Consecutive new patients with a histopathology proven colorectal cancer for whom a CRC treatment plan is made: * In an multi-disciplinary team meeting (MDT); * OR in the outpatient clinic where an MDT is not available (surgery, oncology or radiotherapy outpatient clinic). AND • Undergoing treatment in the hospital where the MDT took place
Exclusion criteria
* Patients with no histopathology available * Telephone follow-up not possible
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Catastrophic Expenditure at 6 months | 6 months after treatment decision | Catastrophic expenditure (CE) will be defined as out of pocket payments for CRC treatment greater than 40% of patient income (assessed by an in-person questionnaire led by a researcher). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Catastrophic Expenditure at 3 months | 3 months after treatment decision | Catastrophic expenditure (CE) will be defined as out of pocket payments for CRC treatment greater than 40% of patient income (assessed by an in-person questionnaire led by a researcher). |
| Treatment compliance at 6 weeks | 6 weeks after treatment decision | A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion. |
| Treatment compliance at 3 months | 3 months after treatment decision | A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion. |
| Catastrophic Expenditure at 6 weeks | 6 weeks after treatment decision | Catastrophic expenditure (CE) will be defined as out of pocket payments for CRC treatment greater than 40% of patient income (assessed by an in-person questionnaire led by a researcher). |
| Identification of the main drivers of treatment cost | 6 months after treatment decision | 5 most expensive items or services during colorectal cancer treatment |
| Colorectal cancer stage at the time of diagnosis | At the time of colorectal cancer diagnosis (coincident with timing of patient enrolment in the study) | AJCC (American Joint Committee on Cancer) guidance - 8th edition |
| Treatment compliance at 6 months | 6 months after treatment decision | A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion. |
Contacts
Primary ContactAneel Bhangu, PhD
Backup ContactJoana Simoes, Master
Outcome results
None listed