Improvement of colorectal cancer patient experience with a regional cancer plan in Sweden

Colorectal Cancer

Colorectal Dis. 2020 Aug 1. doi: 10.1111/codi.15289. Online ahead of print.


AIM: The Stockholm-Gotland Regional Cancer Plan was launched in 2012 to improve cancer care. Implementation of a personal contact nurse (CN), an Individual Written Care Plan (IWCP) and a Standardized Care Pathway (SCP) were introduced. The aim of the current study was to evaluate whether these efforts have resulted in an improved patient experience in patients treated for colorectal cancer.

METHOD: Patients treated with bowel resection for colorectal cancer in the Stockholm-Gotland region during Jan 1st 2013 to Dec 31st 2017 were identified through the Swedish Colorectal Cancer Registry. Six to eight months postoperatively the patients received a Patient Reported Experience questionnaire. Patients were classified as "satisfied" or "not satisfied".

RESULTS: The questionnaire was sent to 4465 patients and 3154 (70.64%) responded. The proportion of patients assigned a CN increased over time (79.84% to 88.44%) and so did the proportion of patients receiving an IWCP (39.36% to 70.00%). The waiting times were significantly shortened during the study period. In multivariable analysis, access to CN and IWCP were independently associated with increased patient satisfaction (OR 3.03, 95% CI 2.28-4.02 and OR 1.64, 95% CI 1.38-1.94). Patients with long waiting time were significantly less satisfied than patients with short waiting time (OR 0.72, CI 0.60-0.88).

CONCLUSION: Implementation of CN, IWCP and SCP has been successful, measured by a higher proportion of patients getting access to these assets and shortened waiting times. This has led to an improved patient experience in patients treated for colorectal cancer in the Stockholm-Gotland region.