Effect of nurse case management on the treatment of older women with breast cancer

James Goodwin, Shiva Satish, Elizabeth T. Anderson, Ann B. Nattinger, Jean L. Freeman

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

OBJECTIVES: To evaluate the effect of nurse case management on the treatment of older women with breast cancer. DESIGN: Randomized prospective trial. SETTING: Sixty surgeons practicing at 13 community and two public hospitals in southeast Texas. PARTICIPANTS: Three hundred thirty-five women (166 control and 169 intervention) aged 65 and older newly diagnosed with breast cancer. INTERVENTION: Women seeing surgeons randomized to the intervention group received the services of a nurse case manager for 12 months after the diagnosis of breast cancer. MEASUREMENTS: The primary outcome was the type and use of cancer-specific therapies received in the first 6 months after diagnosis. Secondary outcomes were patient satisfaction and arm function on the affected side 2 months after diagnosis. RESULTS: More women in the intervention group received breast-conserving surgery (28.6% vs 18.7%; P = .031) and radiation therapy (36.0% vs 19.0%; P = .003). Of women undergoing breast-conserving surgery, greater percentages in the case management group received adjuvant radiation (78.3% vs 44.8%; P = .001) and axillary dissection (71.4% vs 44.8%; P = .057). Women in the case management group were also more likely to receive more breast reconstruction surgery (9.3% vs 2.6%, P = .054), and women in the case management group with advanced cancer were more likely to receive chemotherapy (72.7% vs 30.0%, P = .057). Two months after surgery, higher percentages of women in the case manager group had normal arm function (93% vs 84%; P = .037) and were more likely to state that they had a real choice in their treatment (82.2% vs 69.9%, P = .020). Women with indicators of poor social support were more likely to benefit from nurse case management. CONCLUSION: Nurse case management results in more appropriate management of older women with breast cancer.

Original languageEnglish (US)
Pages (from-to)1252-1259
Number of pages8
JournalJournal of the American Geriatrics Society
Volume51
Issue number9
DOIs
StatePublished - Sep 1 2003

Fingerprint

Case Management
Nurses
Breast Neoplasms
Therapeutics
Segmental Mastectomy
Mammaplasty
Public Hospitals
Patient Satisfaction
Social Support
Dissection
Neoplasms
Radiotherapy
Radiation
Drug Therapy

Keywords

  • Access to care
  • Aging
  • Breast cancer
  • Nurse case management
  • Social support

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Effect of nurse case management on the treatment of older women with breast cancer. / Goodwin, James; Satish, Shiva; Anderson, Elizabeth T.; Nattinger, Ann B.; Freeman, Jean L.

In: Journal of the American Geriatrics Society, Vol. 51, No. 9, 01.09.2003, p. 1252-1259.

Research output: Contribution to journalArticle

Goodwin, James ; Satish, Shiva ; Anderson, Elizabeth T. ; Nattinger, Ann B. ; Freeman, Jean L. / Effect of nurse case management on the treatment of older women with breast cancer. In: Journal of the American Geriatrics Society. 2003 ; Vol. 51, No. 9. pp. 1252-1259.
@article{33425c1f1e774fa2856bc1a347827c5e,
title = "Effect of nurse case management on the treatment of older women with breast cancer",
abstract = "OBJECTIVES: To evaluate the effect of nurse case management on the treatment of older women with breast cancer. DESIGN: Randomized prospective trial. SETTING: Sixty surgeons practicing at 13 community and two public hospitals in southeast Texas. PARTICIPANTS: Three hundred thirty-five women (166 control and 169 intervention) aged 65 and older newly diagnosed with breast cancer. INTERVENTION: Women seeing surgeons randomized to the intervention group received the services of a nurse case manager for 12 months after the diagnosis of breast cancer. MEASUREMENTS: The primary outcome was the type and use of cancer-specific therapies received in the first 6 months after diagnosis. Secondary outcomes were patient satisfaction and arm function on the affected side 2 months after diagnosis. RESULTS: More women in the intervention group received breast-conserving surgery (28.6{\%} vs 18.7{\%}; P = .031) and radiation therapy (36.0{\%} vs 19.0{\%}; P = .003). Of women undergoing breast-conserving surgery, greater percentages in the case management group received adjuvant radiation (78.3{\%} vs 44.8{\%}; P = .001) and axillary dissection (71.4{\%} vs 44.8{\%}; P = .057). Women in the case management group were also more likely to receive more breast reconstruction surgery (9.3{\%} vs 2.6{\%}, P = .054), and women in the case management group with advanced cancer were more likely to receive chemotherapy (72.7{\%} vs 30.0{\%}, P = .057). Two months after surgery, higher percentages of women in the case manager group had normal arm function (93{\%} vs 84{\%}; P = .037) and were more likely to state that they had a real choice in their treatment (82.2{\%} vs 69.9{\%}, P = .020). Women with indicators of poor social support were more likely to benefit from nurse case management. CONCLUSION: Nurse case management results in more appropriate management of older women with breast cancer.",
keywords = "Access to care, Aging, Breast cancer, Nurse case management, Social support",
author = "James Goodwin and Shiva Satish and Anderson, {Elizabeth T.} and Nattinger, {Ann B.} and Freeman, {Jean L.}",
year = "2003",
month = "9",
day = "1",
doi = "10.1046/j.1532-5415.2003.51409.x",
language = "English (US)",
volume = "51",
pages = "1252--1259",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Effect of nurse case management on the treatment of older women with breast cancer

AU - Goodwin, James

AU - Satish, Shiva

AU - Anderson, Elizabeth T.

AU - Nattinger, Ann B.

AU - Freeman, Jean L.

PY - 2003/9/1

Y1 - 2003/9/1

N2 - OBJECTIVES: To evaluate the effect of nurse case management on the treatment of older women with breast cancer. DESIGN: Randomized prospective trial. SETTING: Sixty surgeons practicing at 13 community and two public hospitals in southeast Texas. PARTICIPANTS: Three hundred thirty-five women (166 control and 169 intervention) aged 65 and older newly diagnosed with breast cancer. INTERVENTION: Women seeing surgeons randomized to the intervention group received the services of a nurse case manager for 12 months after the diagnosis of breast cancer. MEASUREMENTS: The primary outcome was the type and use of cancer-specific therapies received in the first 6 months after diagnosis. Secondary outcomes were patient satisfaction and arm function on the affected side 2 months after diagnosis. RESULTS: More women in the intervention group received breast-conserving surgery (28.6% vs 18.7%; P = .031) and radiation therapy (36.0% vs 19.0%; P = .003). Of women undergoing breast-conserving surgery, greater percentages in the case management group received adjuvant radiation (78.3% vs 44.8%; P = .001) and axillary dissection (71.4% vs 44.8%; P = .057). Women in the case management group were also more likely to receive more breast reconstruction surgery (9.3% vs 2.6%, P = .054), and women in the case management group with advanced cancer were more likely to receive chemotherapy (72.7% vs 30.0%, P = .057). Two months after surgery, higher percentages of women in the case manager group had normal arm function (93% vs 84%; P = .037) and were more likely to state that they had a real choice in their treatment (82.2% vs 69.9%, P = .020). Women with indicators of poor social support were more likely to benefit from nurse case management. CONCLUSION: Nurse case management results in more appropriate management of older women with breast cancer.

AB - OBJECTIVES: To evaluate the effect of nurse case management on the treatment of older women with breast cancer. DESIGN: Randomized prospective trial. SETTING: Sixty surgeons practicing at 13 community and two public hospitals in southeast Texas. PARTICIPANTS: Three hundred thirty-five women (166 control and 169 intervention) aged 65 and older newly diagnosed with breast cancer. INTERVENTION: Women seeing surgeons randomized to the intervention group received the services of a nurse case manager for 12 months after the diagnosis of breast cancer. MEASUREMENTS: The primary outcome was the type and use of cancer-specific therapies received in the first 6 months after diagnosis. Secondary outcomes were patient satisfaction and arm function on the affected side 2 months after diagnosis. RESULTS: More women in the intervention group received breast-conserving surgery (28.6% vs 18.7%; P = .031) and radiation therapy (36.0% vs 19.0%; P = .003). Of women undergoing breast-conserving surgery, greater percentages in the case management group received adjuvant radiation (78.3% vs 44.8%; P = .001) and axillary dissection (71.4% vs 44.8%; P = .057). Women in the case management group were also more likely to receive more breast reconstruction surgery (9.3% vs 2.6%, P = .054), and women in the case management group with advanced cancer were more likely to receive chemotherapy (72.7% vs 30.0%, P = .057). Two months after surgery, higher percentages of women in the case manager group had normal arm function (93% vs 84%; P = .037) and were more likely to state that they had a real choice in their treatment (82.2% vs 69.9%, P = .020). Women with indicators of poor social support were more likely to benefit from nurse case management. CONCLUSION: Nurse case management results in more appropriate management of older women with breast cancer.

KW - Access to care

KW - Aging

KW - Breast cancer

KW - Nurse case management

KW - Social support

UR - http://www.scopus.com/inward/record.url?scp=0042834209&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0042834209&partnerID=8YFLogxK

U2 - 10.1046/j.1532-5415.2003.51409.x

DO - 10.1046/j.1532-5415.2003.51409.x

M3 - Article

VL - 51

SP - 1252

EP - 1259

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 9

ER -