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Rafn BS, Hung S, Hoens AM, McNeely ML, Singh CA, Kwan W, Dingee C, McKevitt EC, Kuusk U, Pao J, Van Laeken N, Goldsmith CH, Campbell KL. Prospective surveillance and targeted physiotherapy for arm morbidity after breast cancer surgery: a pilot randomized controlled trial. Clin Rehabil 2018; 32:811-826. [PMID: 29473482 DOI: 10.1177/0269215518757292] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate prospective surveillance and targeted physiotherapy (PSTP) compared to education (EDU) on the prevalence of arm morbidity and describe the associated program cost. DESIGN Pilot randomized single-blinded controlled trial. SETTING Urban with assessments and treatment delivered in hospitals. PARTICIPANTS Women scheduled for breast cancer surgery. INTERVENTIONS Participants were randomly assigned (1:1) to PSTP ( n = 21) or EDU ( n = 20) and assessed presurgery and 12 months postsurgery. All participants received usual care, namely, preoperative education and provision of an education booklet with postsurgical exercises. The PSTP group was monitored for arm morbidity every three months and referred for physiotherapy if arm morbidity was identified. The EDU group received three education sessions on nutrition, stress and fatigue management. MAIN OUTCOME MEASURES Arm morbidity was based on changes in the surgical arm(s) from presurgery in four domains: (1) shoulder range of motion, (2) strength, (3) volume, and (4) upper body function. Complex arm morbidity indicated ≥2 domains impaired. Second, the cost of the PSTP program was described. RESULTS At 12 months, 18 (49%) participants (10 PSTP and 8 EDU) had arm morbidity, with EDU participants presenting more complex arm morbidity compared to PSTP participants. PSTP participants attended 4.4 of 5 assessments with 90% retention. The PSTP program cost was $150 covered by the Health Care Provider and the Patient Out-of-Pocket Travel cost was CAN$40. CONCLUSION Our results suggest that PSTP is feasible among women with breast cancer for early identification of arm morbidity. A larger study is needed to determine the cost and effectiveness benefits.
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Affiliation(s)
- Bolette S Rafn
- 1 Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada
| | - Stanley Hung
- 1 Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada
| | - Alison M Hoens
- 1 Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada
| | - Margaret L McNeely
- 2 Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | | | - Winkle Kwan
- 4 Fraser Valley Centre, BC Cancer Agency, Vancouver, BC, Canada
| | - Carol Dingee
- 5 Department of Surgery, The University of British Columbia, Vancouver, BC, Canada
| | - Elaine C McKevitt
- 5 Department of Surgery, The University of British Columbia, Vancouver, BC, Canada
| | - Urve Kuusk
- 5 Department of Surgery, The University of British Columbia, Vancouver, BC, Canada
| | - Jinsi Pao
- 5 Department of Surgery, The University of British Columbia, Vancouver, BC, Canada
| | - Nancy Van Laeken
- 5 Department of Surgery, The University of British Columbia, Vancouver, BC, Canada
| | - Charlie H Goldsmith
- 6 Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,7 Department of Occupational Science & Occupational Therapy, The University of British Columbia, Vancouver, BC, Canada
| | - Kristin L Campbell
- 1 Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada
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Blais C, Jean S, Sirois C, Rochette L, Plante C, Larocque I, Doucet M, Ruel G, Simard M, Gamache P, Hamel D, St-Laurent D, Emond V. Quebec Integrated Chronic Disease Surveillance System (QICDSS), an innovative approach. Chronic Dis Inj Can 2014; 34:226-235. [PMID: 25408182] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION With the growing burden of chronic diseases, surveillance will play an essential role in improving their prevention and control. The Institut national de santé publique du Québec has developed an innovative chronic disease surveillance system, the Quebec Integrated Chronic Disease Surveillance System (QICDSS). We discuss the primary features, strengths and limitations of this system in this report. METHODS The QICDSS was created by linking five health administrative databases. Updated annually, it currently covers the period from January 1, 1996, to March 31, 2012. The operational model comprises three steps: (1) extraction and linkage of health administrative data according to specific selection criteria; (2) analysis (validation of case definitions essentially) and production of surveillance measures; and (3) data interpretation, submission and dissemination of information. The QICDSS allows the surveillance of the following chronic diseases: diabetes, cardiovascular diseases, respiratory diseases, osteoporosis, osteoarticular diseases, mental disorders, Alzheimer's disease and related disorders. The system also lends itself to the analysis of multimorbidity and polypharmacy. RESULTS For 2011-2012, the QICDSS contained information on 7 995 963 Quebecers with an average age of 40.8 years. Of these, 95.3% met at least one selection criterion allowing the application of case definitions for chronic disease surveillance. The actual proportion varied with age, from 90.1% for those aged 19 years or less to 99.3% for those aged 65 years or over. CONCLUSION The QICDSS provides a way of producing population-based data on the chronic disease burden, health services and prescription drug uses. The system facilitates the integrated study of several diseases in combination, an approach rarely implemented until now in the context of population surveillance. The QICDSS possesses all the essential features of a surveillance system and supports the dissemination of information to public health decision-makers for future actions.
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Affiliation(s)
- C Blais
- Institut national de santé publique du Québec, Québec, Quebec, Canada; Faculté de pharmacie, Université Laval, Québec, Quebec, Canada
| | - S Jean
- Institut national de santé publique du Québec, Québec, Quebec, Canada; Faculté de médecine, Université Laval, Québec, Quebec, Canada; Département de médecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - C Sirois
- Institut national de santé publique du Québec, Québec, Quebec, Canada; Département de sciences infirmières, Université du Québec à Rimouski, Lévis, Quebec, Canada
| | - L Rochette
- Institut national de santé publique du Québec, Québec, Quebec, Canada
| | - C Plante
- Institut national de santé publique du Québec, Québec, Quebec, Canada
| | - I Larocque
- Institut national de santé publique du Québec, Québec, Quebec, Canada
| | - M Doucet
- Institut national de santé publique du Québec, Québec, Quebec, Canada; Faculté de médecine, Université Laval, Québec, Quebec, Canada
| | - G Ruel
- Institut national de santé publique du Québec, Québec, Quebec, Canada; Population Research Outcome Studies (PROS), University of Adelaide, Adelaide, South Australia, Australia
| | - M Simard
- Institut national de santé publique du Québec, Québec, Quebec, Canada
| | - P Gamache
- Institut national de santé publique du Québec, Québec, Quebec, Canada
| | - D Hamel
- Institut national de santé publique du Québec, Québec, Quebec, Canada
| | - D St-Laurent
- Institut national de santé publique du Québec, Québec, Quebec, Canada
| | - V Emond
- Institut national de santé publique du Québec, Québec, Quebec, Canada
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