Use of Chinese Medicine Among Survivors of Nasopharyngeal Carcinoma in Taiwan: A Population-Based Study
ABSTRACT Hypotheses. The authors hypothesized that the use of alternative medicine, in the form of Chinese medicine (CM), among patients in the continuing care phase of nasopharyngeal carcinoma (NPC) in Taiwan is higher than the use in a matched control group of noncancer individuals.
This was a case-control study.
Using a population-based claim database, the authors identified 181 long-term survivors of NPC and 905 matched controls. They obtained information on CM use and associated cost as outcome measures. Descriptive analysis and regression models were applied to examine the association between NPC and the outcome measures.
The unadjusted CM initiation (34% vs 32%; P = .54), intensity of use (2.15 vs 1.73 visits; P = .37), and cost (US$79 vs US$58; P = .16) were higher for patients in the NPC group than for those in the control group. Regression analyses suggested that the NPC group had significantly more CM visits (1.01; 95% confidence interval = 0.07-1.96), and more than 50% of these visits were related to cancer.
The authors confirmed their hypotheses that the use of CM in the continuing care phase by patients with NPC in Taiwan was higher than the use in their matched, noncancer counterparts. These findings suggest that current clinical surveillance strategies for NPC might not meet patients' physical and emotional needs.
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ABSTRACT: Aim. The objectives of this study were to compare yang-xu, yin-xu, and yu among patients with breast cancer right before, one month after, and three months after receiving target, chemo, or combined therapy. Method. After recruiting 126 patients from 4 hospitals in northern Taiwan, a longitudinal study was carried out with 61 patients receiving chemotherapy, 30 receiving target therapy, and 35 receiving combined therapy. Yang-xu, yin-xu, and yu were assessed using the Traditional Chinese Medical Constitutional Scale (TCMCS), with higher scores indicating more xu and yu. Results. There were significant increases in yang-xu, yin-xu, and yu at 1 month and 3 months after than before the start of the chemotherapy, target, or combined therapy. Patients receiving combined therapy had significantly higher scores in yang-xu and yin-xu than patients receiving chemo or target therapy. A history of coronary heart disease was associated with more yin-xu. Those patients who had undergone a mastectomy were associated with less yu zheng than those patients who had not. Conclusion and Implications. TCM doctors should focus their treatment on dealing with xu and yu in order to support their patients, as they complete their modern anticancer treatments.Evidence-based Complementary and Alternative Medicine 03/2013; 2013:392024. DOI:10.1155/2013/392024 · 1.88 Impact Factor
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ABSTRACT: Background The addition of thoracic radiotherapy improves the outcome of limited stage small cell lung cancer (LS-SCLC). The cost-effectiveness has never been reported. We aimed to estimate the short-term cost-effectiveness of chemotherapy combined with thoracic radiotherapy (C-TRT) vs chemotherapy alone (C/T) for LS-SCLC patients from the payer's perspective (Taiwan National Health Insurance).Methods We identified LS-SCLC patients diagnosed within 2007-2009 through a comprehensive population-based database containing cancer registry, death registry, and reimbursement data. The duration of interest was one year within diagnosis. We included potential confounding covariables though literature searching and our own experiences and used propensity score (PS) to construct a 1:1 population for adjustment. We used net benefit (NB) approach to evaluate the cost-effectiveness at various willingness-to-pay (WTP) levels. Sensitivity analysis regarding potential unmeasured confounder(s) was performed.ResultsOur study population constituted 74 patients. The mean cost (2013 USD) and survival (year) was higher for C-TRT (42437 vs 28357 for cost; 0.94 vs 0.88 for survival). At the common WTP level (50,000 USD/life-year), T-CRT was not cost effective (incremental NB -11,082) and the probability for T-CRT to be cost effective (i.e., positive net benefit) was 0.005. The result was moderate sensitive to potential unmeasured confounder(s) in sensitivity analysis.Conclusions We provide the first evidence that when compared to C/T, C-TRT is effective in improving survival but is not cost-effective in the short-term at common WTP level from payer's perspective. This information would be considered for clinicians when discussing with their LS-SCLC patients regarding thoracic radiotherapy.04/2014; 5(6). DOI:10.1111/1759-7714.12125
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ABSTRACT: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive alternative to conventional surgery (CS). We aimed to estimate the short-term cost-effectiveness of VATS vs. CS for clinical stage I non-small cell lung cancer (NSCLC-c-stage-I) patients from the payer's perspective (National Health Insurance). We identified NSCLC-c-stage-I patients diagnosed and received surgery within 2007-2009 through a comprehensive population-based database containing cancer and death registries, and reimbursement data. The duration of interest was 1 year. We included potential confounding covariables through literature searching and our own experience, and used a propensity score to construct a 1:1 population for adjustment. Our study population constituted 966 patients. The mean hospital stay [days, standard deviation (SD)] were 14.4  and 16.1 (7.7) for VATS and CS respectively (P=0.002). The mean cost (2013 USD) and survival (year) was $22,316 vs. $21,976 and 0.98 vs. 0.974 for VATS vs. CS. The probability for VATS to be cost-effective (i.e., positive net benefit) was 0.49 & 0.56 at willingness-to-pay (WTP) 50,000 & 100,000 USD/life-year, respectively. We provide the first empirical evidence that when compared to CS, VATS was potentially cost-effective in the short term (1 year) within the common WTP levels in Taiwan.