dc.contributor.author | Griffiths, RI | |
dc.contributor.author | McFadden, EC | |
dc.contributor.author | Stevens, RJ | |
dc.contributor.author | Valderas, JM | |
dc.contributor.author | Lavery, BA | |
dc.contributor.author | Khan, NF | |
dc.contributor.author | Keating, NL | |
dc.contributor.author | Bankhead, CR | |
dc.date.accessioned | 2018-10-30T10:49:10Z | |
dc.date.issued | 2018-10-06 | |
dc.description.abstract | 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. | en_GB |
dc.description.sponsorship | This study was funded by the Population Research Committee, Cancer Research UK. Quality and Outcomes of Care for Chronic Conditions in Older Patients Diagnosed with Breast, Colorectal, or Prostate Cancer Compared to Non-Cancer Controls: An Observational Study Using the Clinical Practice Research Datalink (CPRD). Reference # 16609. 1 July 2013–29 February, 2016. In addition, Dr. Keating is supported by K24CA181510 from the US National Cancer Institute. | en_GB |
dc.identifier.citation | Published online 6 October 2018 | en_GB |
dc.identifier.doi | 10.1007/s11764-018-0717-5 | |
dc.identifier.uri | http://hdl.handle.net/10871/34548 | |
dc.language.iso | en | en_GB |
dc.publisher | Springer | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/30291561 | en_GB |
dc.rights | © The Author(s) 2018. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. | en_GB |
dc.subject | Diabetes mellitus | en_GB |
dc.subject | Neoplasms | en_GB |
dc.subject | Primary health care | en_GB |
dc.subject | Quality indicators | en_GB |
dc.subject | Quality of health care | en_GB |
dc.title | Quality of diabetes care in breast, colorectal, and prostate cancer | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2018-10-30T10:49:10Z | |
exeter.place-of-publication | United States | en_GB |
dc.description | This is the final version. Available on open access from Springer via the DOI in this record | en_GB |
dc.identifier.journal | Journal of Cancer Survivorship | en_GB |