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Enhancing the Status of Quality of Life Diagnostics in Caring for Breast Cancer Patients: Results From a Multilevel Implementation Study in a Regional Tumor Centre

Phase 1
18 Years
Not Enrolling
Breast Neoplasms

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Trial Information

Enhancing the Status of Quality of Life Diagnostics in Caring for Breast Cancer Patients: Results From a Multilevel Implementation Study in a Regional Tumor Centre

Improving cancer patients' quality of life (QL) requires that QL-diagnostics, the
availability of QL-enhancing treatment options and treatment decisions are being integrated
into a clinical path. This description presents the development and implementation of such a
clinical path in the Tumorcenter Regensburg.

The acting persons and institutions in this clinical path are the breast cancer patients,
the hospitals, the family doctors or gynaecologists, and a QL-study team. Starting point is
the QL-assessment either in the hospital or in doctors' practice (EORTC QLQ-C30 plus BR-23).
The caring physician documents the patients' health status. Based on these two pieces of
information, the QL-study team writes up a medical/QL-opinion plus therapy recommendation.
This report is sent to the caring physician. The effectiveness of the therapy recommendation
is assessed in the following QL-assessment. This clinical path is implemented via three
interrelated methods of implementation: local opinion leaders, outreach visits, and quality

A total of 38 physicians were made familiar with QL-diagnostics through outreach visits, and
12 opinion leaders were identified and convinced to support this project. The quality circle
provided regular CME meetings on QL-enhancing therapy options (pain control, psychotherapy,
physiotherapy, nutrition, social rehabilitation). A total of 170 QL-reports were sent to
physicians. All 38 doctors found the QL-profiles comprehensible and the therapy
recommendations clinically relevant. The most common QL-problems were emotional functioning,
fatigue, and arm/shoulder problems.

QL-diagnostics is a new way to individualise and to rationalise patient care. It transforms
the QL-concept into a decision-relevant, integral part of a clinical path that aims to
provide high quality patient care.

Inclusion Criteria:

- All patients with primary breast cancer in the county of Regensburg, Amberg and
Sulzbach-Rosenberg in the year 2003 to June 2004 submitted by coordinating physicians
who were trained in quality of life questionnaires and profiles.

Exclusion Criteria:

- Secondary breast cancer, patients who refused to participate, patients incapable of
filling out questionnaires, male patients, pregnant patients, age below 18 yrs.

Type of Study:


Study Design:

Additional Descriptors: Psychosocial, Observational Model: Defined Population, Time Perspective: Longitudinal, Time Perspective: Prospective

Principal Investigator

Monika KS Klinkhammer-Schalke, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Tumorzentrum Regensburg e.V.


Germany: Ethics Commission

Study ID:




Start Date:

December 2002

Completion Date:

June 2004

Related Keywords:

  • Breast Neoplasms
  • Quality of Life
  • Breast Cancer
  • Referee's Report
  • Diagnostics
  • Therapy
  • Breast Neoplasms
  • Neoplasms