Follow-up of cancer patients at the Colorectal Multidisciplinary Clinic: The University of the Philippines - Philippine General Hospital (UP-PGH) experience.

Abstract

e18022 Background: The University of the Philippines - Philippine General Hospital (UP-PGH) Colorectal Multidisciplinary Team is composed of colorectal surgeons, radiation oncologists, and medical oncologists tasked with the care of patients with colon and rectal cancers in a multidisciplinary clinic. Patients that have been lost to follow-up after initial work-up and treatment return later with more advanced disease if at all they come back for treatment. This is a concern because cancers of the colon and rectum are potentially curable if addressed in a timely manner by patient and physician. Moreover, aggressive follow-up of potentially curable colon and rectal cancers has been shown to improve patient outcomes. Identifying factors that contribute to poor patient follow-up will allow the team to design strategies that will lead to more patients completing treatment. This study aimed to identify the different factors that influence follow-up among Filipino cancer patients presenting at the UP-PGH Colorectal multidisciplinary clinic. Methods: This is a 6 month prospective cross-sectional pilot study where a questionnaire was designed to evaluate patient views regarding factors that contribute to continued follow-up as well as factors associated with poor follow-up at the colorectal multidisciplinary clinic. Patients were allowed to state multiple factors as they see fit. Descriptive statistics were employed in the analysis of data. Results: Of the 97 responders, 39 (40%) patients identified belief in the effectiveness of the treatment and trust in their physicians, 33 (34%) stated adequacy of family support , and 31 (32%) noted affordability of treatment as factors contributing to patient follow-up. In contrast, 44 (45%) patients identified financial constraints, and 7 (7%) stated the far distance of their home to the treatment center as potential causes of poor follow-up. Other potential causes of poor follow-up identified were fear and anxiety about treatment, intolerable side-effects, and long lines at the clinic -all with 2 (2%) responses each. Conclusions: Healthcare decisions in the Philippines are affected by an interplay of factors. This study has identified belief in treatment efficacy, trust in their attending physician, financial factors, and clinic accessibility as influencing continued patient follow-up. Future endeavors may be directed towards these factors to improve follow-up and care at the colorectal multidisciplinary clinic.