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Aleshchenko E, Apfelbacher C, Baust K, Calaminus G, Droege P, Glogner J, Horenkamp-Sonntag D, Ihle P, Kaatsch P, Klein M, Kloppe T, Kuepper-Nybelen J, Langer T, Luepkes C, Marschall U, Meier I, Merzenich H, Spix C, Swart E, Trocchi P. VersKiK: Study protocol of an observational registry-based study on the current state of follow-up care and adherence to follow-up guidelines after cancer in childhood or adolescence. Cancer Epidemiol 2023; 87:102469. [PMID: 37806118 DOI: 10.1016/j.canep.2023.102469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/14/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND This article describes the study design of the quantitative part of the VersKiK study, The primary objectives of this study are to examine the occurrence of late effects in survivors of childhood or adolescent cancer (module 1), investigate health-related vulnerabilities and medical service utilization within this survivor group (modules 1 and 3), and assess the alignment between documented follow-up care for cardiological and audiological late effects with guideline recommendations, along with evaluating the extent of adherence among paediatric cancer survivors (module 3). METHODS This is a non-interventional retrospective observational cohort study. It is based on stochastically linked insurance claims data from approximately 150,000 statutory insured persons with information concerning around 25,000-30,000 cancer survivors recorded in the German Childhood Cancer Register (GCCR). To explore adherence to selected follow-up guidelines, intention to treat treatment data from clinical study groups for particular diagnostic entities will be additionally included. DISCUSSION The growing group of survivors after cancer in childhood and adolescence is representing a special population with an increasing demand for life-long healthcare services through relative high probability of late effects. Currently, there is a limited evidence in Germany on utilization of corresponding medical services and adherence to follow-up guidelines. With this study design, we are aiming to address these gaps and, consequently, suggest improvements to existing follow-up guidelines and follow-up care provision in Germany.
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Affiliation(s)
- E Aleshchenko
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke Univiersity, Magdeburg, Germany.
| | - C Apfelbacher
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke Univiersity, Magdeburg, Germany
| | - K Baust
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - G Calaminus
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - P Droege
- Health Services and Quality Research, Research Institute of the Local Health Care Funds (WIdO), Berlin, Germany
| | - J Glogner
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | | | - P Ihle
- PMV research group at the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Cologne, Köln, Germany
| | - P Kaatsch
- German Childhood Cancer Registry, Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - M Klein
- DAK-Gesundheit, Hamburg, Germany
| | - T Kloppe
- OFFIS-Institute for Information Technology, Oldenburg, Germany
| | - J Kuepper-Nybelen
- PMV research group at the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Cologne, Köln, Germany
| | - T Langer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - C Luepkes
- OFFIS-Institute for Information Technology, Oldenburg, Germany
| | | | - I Meier
- Techniker Krankenkasse (TK), Hamburg, Germany
| | - H Merzenich
- German Childhood Cancer Registry, Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - C Spix
- German Childhood Cancer Registry, Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - E Swart
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke Univiersity, Magdeburg, Germany
| | - P Trocchi
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke Univiersity, Magdeburg, Germany
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Aleshchenko E, Swart E, Spix C, Voigt M, Trocchi P, Langer T, Calaminus G, Baust K, Glogner J, Ihle P, Küpper-Nybelen J, Lüpkes C, Kloppe T, Horenkamp-Sonntag D, Meier I, Marschall U, Dröge P, Klein M, Weiss A, Apfelbacher C. Long-term care, care needs and wellbeing of individuals after cancer in childhood or adolescence (VersKiK): study protocol of a large scale multi-methods non-interventional study. BMC Health Serv Res 2022; 22:1176. [PMID: 36127717 PMCID: PMC9487026 DOI: 10.1186/s12913-022-08549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been shown previously that a relevant proportion of childhood cancer survivors suffers from late effects, which are often directly related to the cancer itself or its therapy, resulting in particular follow-up needs, additionally burdening healthcare systems. Being diagnosed with cancer at a vulnerable stage of development, this group of cancer survivors is at comparatively higher risk of relapse or subsequent cancer. Although national and international follow-up guidelines based on treatment modalities have been developed, their implementation seems to leave room for improvement. Additionally, they lack a sufficient consideration of the survivors' psychosocial needs, affecting their adherence to them. The aim of the VersKiK study is to provide representative information on late effects in childhood and adolescence cancer survivors in Germany. The main research objectives are: (1) to describe the state of follow-up care among survivors after a cancer diagnosis in childhood or adolescence; (2) to quantify the occurrence of late effects among this group of survivors; (3) to examine the adherence to selected audiological and cardiological follow-up guidelines and to identify factors affecting it; (4) to explore actual follow-up needs of paediatric cancer survivors; (5) to review selected follow-up guidelines with the aim to improve and expand them. METHODS VersKiK is designed as a mixed-methods non-interventional study. We will use claims data from statutory health insurance companies in combination with individually linked population-based registry data from the German Childhood Cancer Registry (GCCR). This data base will permit us to quantify diagnoses and procedures in comparison to the general population as well as the adherence to existing follow-up guidelines. Additional information will be obtained through interviews with childhood and adolescence cancer survivors and their informal caregivers, as well as in focus groups with healthcare professionals. DISCUSSION The present study aims to research the actual needs of individuals after cancer diagnosis and treatment in childhood or adolescence - physical, psychological and organisational - in order to improve existing follow-up guidelines. These improvements might further positively affect not only actual care provided to paediatric cancer survivors, but also benefit healthcare systems in general while decreasing consequent medical visits in this group of patients. TRIAL REGISTRATION Registered at German Clinical Trial Register (ID: DRKS00025960 and DRKS00026092).
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Affiliation(s)
- E Aleshchenko
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto Von Guericke Univiersity, Magdeburg, Germany.
| | - E Swart
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto Von Guericke Univiersity, Magdeburg, Germany
| | - C Spix
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - M Voigt
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - P Trocchi
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto Von Guericke Univiersity, Magdeburg, Germany
| | - T Langer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - G Calaminus
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - K Baust
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - J Glogner
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - P Ihle
- PMV Research Group at the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Cologne, Köln, Germany
| | - J Küpper-Nybelen
- PMV Research Group at the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Cologne, Köln, Germany
| | - C Lüpkes
- OFFIS-Institute for Information Technology, Oldenburg, Germany
| | - T Kloppe
- OFFIS-Institute for Information Technology, Oldenburg, Germany
| | | | - I Meier
- Techniker Krankenkasse (TK), Hamburg, Germany
| | | | - P Dröge
- AOK Research Institute (WIdO), Berlin, Germany
| | - M Klein
- DAK-Gesundheit, Hamburg, Germany
| | - A Weiss
- Medical Sociology, Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.,Bavarian Care and Nursing Authority, Amberg, Germany
| | - C Apfelbacher
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto Von Guericke Univiersity, Magdeburg, Germany
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Trocchi P, Swart E, Aleshchenko E, Spix C, Voigt M, Lüpkes C, Ihle P, Küpper-Nybelen J, Meier I, Horenkamp-Sonntag D, Dröge P, Marschall U, Klein M, Calaminus G, Baust K, Langer T, Apfelbacher C. Zusammenführung von Daten aus dem Deutschen
Kinderkrebsregister (DKKR) mit Routinedaten aus gesetzlichen Krankenkassen:
methodische Aspekte aus der VersKiK-Studie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- P Trocchi
- Medizinische Fakultät der Otto-von-Guericke Universität
Magdeburg, Institut für Sozialmedizin und Gesundheitssystemforschung
(ISMG), Magdeburg, Deutschland
| | - E Swart
- Medizinische Fakultät der Otto-von-Guericke Universität
Magdeburg, Institut für Sozialmedizin und Gesundheitssystemforschung
(ISMG), Magdeburg, Deutschland
| | - E Aleshchenko
- Medizinische Fakultät der Otto-von-Guericke Universität
Magdeburg, Institut für Sozialmedizin und Gesundheitssystemforschung
(ISMG), Magdeburg, Deutschland
| | - C Spix
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Institut für Medizinische Biometrie, Epidemiologie und
Informatik, Mainz, Deutschland
| | - M Voigt
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Institut für Medizinische Biometrie, Epidemiologie und
Informatik, Mainz, Deutschland
| | - C Lüpkes
- OFFIS e.V., Oldenburg, Deutschland
| | - P Ihle
- Universitätsklinikum Köln, PMV forschungsgruppe,
Köln, Deutschland
| | - J Küpper-Nybelen
- Universitätsklinikum Köln, PMV forschungsgruppe,
Köln, Deutschland
| | - I Meier
- Techniker Krankenkasse, Hamburg, Deutschland
| | | | - P Dröge
- AOK-Bundesverband GbR, Wissenschaftlichen Institut der AOK, Berlin,
Deutschland
| | | | - M Klein
- DAK-Gesundheit, Hamburg, Deutschland
| | - G Calaminus
- Rheinische Friedrich-Wilhelms-Universität Bonn,
Universitätsklinikum Bonn, Zentrum für
Kinderheilkunde/Abteilung für Pädiatrische Onkologie und
Hämatologie, Bonn, Deutschland
| | - K Baust
- Rheinische Friedrich-Wilhelms-Universität Bonn,
Universitätsklinikum Bonn, Zentrum für
Kinderheilkunde/Abteilung für Pädiatrische Onkologie und
Hämatologie, Bonn, Deutschland
| | - T Langer
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck,
Abteilung für Pädiatrische Onkologie und Hämatologie,
Lübeck, Deutschland
| | - C Apfelbacher
- Medizinische Fakultät der Otto-von-Guericke Universität
Magdeburg, Institut für Sozialmedizin und Gesundheitssystemforschung
(ISMG), Magdeburg, Deutschland
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Salchow J, Mann J, Koch B, von Grundherr J, Jensen W, Elmers S, Straub LA, Vettorazzi E, Escherich G, Rutkowski S, Dwinger S, Bergelt C, Sokalska-Duhme M, Bielack S, Calaminus G, Baust K, Classen CF, Rössig C, Faber J, Faller H, Hilgendorf I, Gebauer J, Langer T, Metzler M, Schuster S, Niemeyer C, Puzik A, Reinhardt D, Dirksen U, Sander A, Köhler M, Habermann JK, Bokemeyer C, Stein A. Comprehensive assessments and related interventions to enhance the long-term outcomes of child, adolescent and young adult cancer survivors - presentation of the CARE for CAYA-Program study protocol and associated literature review. BMC Cancer 2020; 20:16. [PMID: 31906955 PMCID: PMC6945396 DOI: 10.1186/s12885-019-6492-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022] Open
Abstract
Background Improved, multimodal treatment strategies have been shown to increase cure rates in cancer patients. Those who survive cancer as a child, adolescent or young adult (CAYA), are at a higher risk for therapy-, or disease-related, late or long-term effects. The CARE for CAYA-Program has been developed to comprehensively assess any potential future problems, to offer need-based preventative interventions and thus to improve long-term outcomes in this particularly vulnerable population. Methods The trial is designed as an adaptive trial with an annual comprehensive assessment followed by needs stratified, modular interventions, currently including physical activity, nutrition and psycho-oncology, all aimed at improving the lifestyle and/or the psychosocial situation of the patients. Patients, aged 15–39 years old, with a prior cancer diagnosis, who have completed tumour therapy and are in follow-up care, and who are tumour free, will be included. At baseline (and subsequently on an annual basis) the current medical and psychosocial situation and lifestyle of the participants will be assessed using a survey compiled of various validated questionnaires (e.g. EORTC QLQ C30, NCCN distress thermometer, PHQ-4, BSA, nutrition protocol) and objective parameters (e.g. BMI, WHR, co-morbidities like hyperlipidaemia, hypertension, diabetes), followed by basic care (psychological and lifestyle consultation). Depending on their needs, CAYAs will be allocated to preventative interventions in the above-mentioned modules over a 12-month period. After 1 year, the assessment will be repeated, and further interventions may be applied as needed. During the initial trial phase, the efficacy of this approach will be compared to standard care (waiting list with intervention in the following year) in a randomized study. During this phase, 530 CAYAs will be included and 320 eligible CAYAs who are willing to participate in the interventions will be randomly allocated to an intervention. Overall, 1500 CAYAs will be included and assessed. The programme is financed by the innovation fund of the German Federal Joint Committee and will be conducted at 14 German sites. Recruitment began in January 2018. Discussion CAYAs are at high risk for long-term sequelae. Providing structured interventions to improve lifestyle and psychological situation may counteract against these risk factors. The programme serves to establish uniform regular comprehensive assessments and need-based interventions to improve long-term outcome in CAYA survivors. Trial registration Registered at the German Clinical Trial Register (ID: DRKS00012504, registration date: 19th January 2018).
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Affiliation(s)
- J Salchow
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - J Mann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Koch
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J von Grundherr
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Jensen
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Elmers
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L A Straub
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Vettorazzi
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Escherich
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Rutkowski
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Dwinger
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Bergelt
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - S Bielack
- Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | | | - K Baust
- University Hospital Bonn, Bonn, Germany
| | - C F Classen
- University Hospital Rostock, Rostock, Germany
| | - C Rössig
- University Children's Hospital Münster, Münster, Germany
| | - J Faber
- Mainz University Medical Center, Mainz, Germany
| | - H Faller
- University Hospital Würzburg, Würzburg, Germany
| | | | - J Gebauer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - T Langer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - M Metzler
- University Hospital Erlangen, Erlangen, Germany
| | - S Schuster
- University Hospital Erlangen, Erlangen, Germany
| | - C Niemeyer
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Puzik
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Reinhardt
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - U Dirksen
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - A Sander
- Hannover Medical School, Hannover, Germany
| | - M Köhler
- Medical Faculty University Hospital Magdeburg, Magdeburg, Germany
| | | | - C Bokemeyer
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stein
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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