Abstract 175P
Background
The National Health System (NHS) Long Term Plan for Cancer prioritises the implementation of Personalised Stratified Follow up and Supported Self-management (SSM) in early breast cancer (EBC). PRAGMATIC evaluated the experiences of EBC patients entering SSM and the impact on quality of life (QoL).
Methods
Three clinical teams in Surrey and Sussex identified EBC patients due to enter SSM. Participants completed questionnaires at baseline, 3, 6, 9 and 12 months to assess QoL (FACT B & EQ-5D-5L), self-efficacy (GSE), psychological morbidity (GHQ-12) and roles and responsibilities (PRRS).
Results
Between February and November 2020, 110 patients were recruited; 99 (90%) completed 12 month assessments. Majority were >50years (91; 83%), had a partner (73; 66%), and on endocrine therapy (86; 78%). 32% (35/110) had received chemotherapy. Patients who had chemotherapy had lower QoL (lower FACT-B) over time compared to the no chemotherapy group, although there was greater improvement compared to baseline at 6, 9 and 12 months. The chemotherapy group also had lower self-efficacy (GSE) scores but there was no statistically significant change over time in either group. Psychological morbidity at baseline (GHQ12 ) had a significant effect on mean FACT-B total score, indicating a considerable QoL decline for patients who had higher levels of psychological morbidity compared to those who did not (mean difference -21.63, 95% confidence interval -27.42 to -15.84). The odds of psychological morbidity were estimated to be 5.5-fold greater for patients who had chemotherapy, although the 95% confidence interval was wide (1.17 - 25.9) due to a small sample size. 10 patients had persistently high levels of psychological morbidity for 12 months. The burden from caring or financial responsibilities (PRRS) was greater for the chemotherapy group, but there was greater improvement at 9 months compared to the no chemotherapy group.
Conclusions
QoL was significantly impacted by high levels of psychological morbidity. BC teams could consider screening all patients for heightened anxiety/depression before starting SSM and offering interventions or closer monitoring for the first 6 months.
Clinical trial identification
ISRCTN10777283.
Editorial acknowledgement
Legal entity responsible for the study
University of Sussex.
Funding
Surrey & Sussex Cancer Alliance.
Disclosure
All authors have declared no conflicts of interest.