Follow-up after surgical treatment in older patients with colorectal cancer: The evaluation of emerging health problems and quality of life after implementation of a standardized shared-care model

Introduction: One-year mortality after hospital discharge is higher among older patients with colorectal cancer who underwent surgery compared to younger patients. Taking care of older adults with multi-morbidity is often fragmented with lack of coordination and information exchange between healthcare professionals. The aim of this study was to evaluate emerging health problems and quality of life after implementing a standardized shared-care model.

Material and Methods: 141 patients aged years who underwent surgery for colorectal carcinoma in two hospitals were included. A standardized transmission from hospital to primary care was set up. Patients' health status and quality of life was evaluated during subsequent follow-up moments.

Results: A reduction in one-year mortality rate from 10.9% to 9.2% was observed after implementation of the standardized shared-care model. Almost all health status domains improved to 'good' during follow-up moments, still the general condition remained poor in 26% of patients at week fourteen. Although quality of life improved during subsequent follow-up moments, fatigue, dyspnoea and insomnia were the most prominent persisting problems at the end of follow-up.

Discussion: The implementation of a standardized shared-care model for older patients after surgery for colorectal cancer resulted in a reduction in the one year mortality rate. Although most aspects of both health status and quality of life improved during subsequent follow-up moments, especially the general condition remained poor for a long time after surgery. This means that, besides a good preoperative counseling of patients, future research should focus on possible interventions to improve general condition. (C) 2018 Elsevier Ltd. All rights reserved.