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ColoRectal Cancer in India: catastrOphiC expenDIture and Referral Pathways infLuencE on Presentation and Treatment

Conditions
Treatment Compliance
Colorectal Cancer
Health Care Utilization
Registration Number
NCT04517032
Lead Sponsor
University of Birmingham
Brief Summary

Observational study to assess barriers for colorectal cancer treatment compliance in India, including quantitative assessment of catastrophic expenditure incidence and qualitative assessment of financial and non-financial barriers.

Detailed Description

Objective: To identify a vulnerable group of colorectal cancer patients in India who cannot afford or are unable to comply with a treatment plan for colorectal cancer.

Aims:

1. To identify the proportion of CRC patients suffering catastrophic expenditure due to out-of-pocket payments for cancer treatment.

2. To determine the proportion of patients who are unable to comply with the treatment plan for CRC, at 6 weeks, 3 months and 6 months after diagnosis.

3. To identify barriers and solutions to CRC treatment compliance. Design: A mixed-methods study comprising quantitative pilot data from 3 tertiary cancer centres and qualitative work from interviews with patients and healthcare professionals.

Participants: Patients diagnosed with primary colorectal cancer.

Outcomes:

Primary outcome:

• Incidence of catastrophic expenditure due to out-of-pocket payments for cancer care at 3 timepoints: 6 weeks, 3 months and 6 months after CRC diagnosis.

Secondary outcomes:

* Compliance to the initial treatment plan at three timepoints: 6 weeks, 3 months and 6 months after CRC diagnosis.

* Patients and healthcare professionals perspectives on patient compliance to CRC treatment.

* Identify the 5 main drivers (items charged to the patient) of CRC treatment cost.

* Colorectal cancer stage at the time of diagnosis.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Catastrophic Expenditure at 6 months6 months after treatment decision

Catastrophic expenditure (CE) will be defined as out of pocket payments for CRC treatment greater than 40% of patient income (assessed by an in-person questionnaire led by a researcher).

Secondary Outcome Measures
NameTimeMethod
Identification of the main drivers of treatment cost6 months after treatment decision

5 most expensive items or services during colorectal cancer treatment

Colorectal cancer stage at the time of diagnosisAt the time of colorectal cancer diagnosis (coincident with timing of patient enrolment in the study)

AJCC (American Joint Committee on Cancer) guidance - 8th edition

Catastrophic Expenditure at 6 weeks6 weeks after treatment decision

Catastrophic expenditure (CE) will be defined as out of pocket payments for CRC treatment greater than 40% of patient income (assessed by an in-person questionnaire led by a researcher).

Catastrophic Expenditure at 3 months3 months after treatment decision

Catastrophic expenditure (CE) will be defined as out of pocket payments for CRC treatment greater than 40% of patient income (assessed by an in-person questionnaire led by a researcher).

Treatment compliance at 6 weeks6 weeks after treatment decision

A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion.

Treatment compliance at 3 months3 months after treatment decision

A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion.

Treatment compliance at 6 months6 months after treatment decision

A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion.

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