A population-based assessment of primary care visits during adjuvant chemotherapy for breast cancer

  • S.J. Bastedo University of Toronto
  • M.K. Krzyzanowska Institute for Clinical Evaluative Sciences; Cancer Care Ontario; Princess Margaret Cancer Centre
  • R. Moineddin Institute for Clinical Evaluative Sciences; University of Toronto
  • L. Yun Institute for Clinical Evaluative Sciences
  • K.A. Enright Trillium Health Partners– Credit Valley Hospital
  • E. Grunfeld Institute for Clinical Evaluative Sciences; University of Toronto; Ontario Institute for Cancer Research
Keywords: Breast cancer, chemotherapy, primary care physicians, emergency room, hospitalization

Abstract

Background

We used administrative health data to explore the impact of primary care physician (pcp) visits on acute-care service utilization by women receiving adjuvant chemotherapy for early-stage breast cancer (ebc).

Methods

Our population-based retrospective cohort study examined pcp visits and acute-care use [defined as an emergency room (er) visit or hospitalization] by women diagnosed with ebc between 2007 and 2009 and treated with adjuvant chemotherapy. Multivariate regression analysis was used to identify the effect of pcp visits on the likelihood of experiencing an acute-care visit.

Results

Patients receiving chemotherapy visited a pcp significantly more frequently than they had before their diagnosis [relative risk (rr): 1.48; 95% confidence interval (ci): 1.44 to 1.53; p < 0.001] and significantly more frequently than control subjects without cancer (rr: 1.51; 95% ci: 1.46 to 1.57; p < 0.001). More than one third of pcp visits by chemotherapy patients were related to breast cancer or chemotherapy-related side effects. In adjusted multivariate analyses, the likelihood of experiencing an er visit or hospitalization increased in the days immediately after a pcp visit (rr: 1.92; 95% ci: 1.76 to 2.10; p < 0.001).

Conclusions

During chemotherapy treatment, patients visited their pcp more frequently than control subjects did, and they visited for reasons related to their breast cancer or to chemotherapy-related side effects. Visits to a pcp by patients receiving chemotherapy were associated with an increased frequency of er visits or hospitalizations in the days immediately after the pcp visit. Those results suggest an opportunity to institute measures for early detection and intervention in chemotherapy side effects.


Author Biographies

S.J. Bastedo, University of Toronto

Institute of Health Policy Management and Evaluation

R. Moineddin, Institute for Clinical Evaluative Sciences; University of Toronto
Department of Family and Community Medicine
E. Grunfeld, Institute for Clinical Evaluative Sciences; University of Toronto; Ontario Institute for Cancer Research
Department of Family and Community Medicine
Published
2017-04-27
How to Cite
Bastedo, S., Krzyzanowska, M., Moineddin, R., Yun, L., Enright, K., & Grunfeld, E. (2017). A population-based assessment of primary care visits during adjuvant chemotherapy for breast cancer. Current Oncology, 24(2), 90-94. https://doi.org/10.3747/co.24.3431
Section
Medical Oncology