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.
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.
Study Type
OBSERVATIONAL
Enrollment
200
Catastrophic Expenditure at 6 months
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).
Time frame: 6 months after treatment decision
Catastrophic Expenditure at 6 weeks
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).
Time frame: 6 weeks after treatment decision
Catastrophic Expenditure at 3 months
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).
Time frame: 3 months after treatment decision
Treatment compliance at 6 weeks
A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion.
Time frame: 6 weeks after treatment decision
Treatment compliance at 3 months
A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion.
Time frame: 3 months after treatment decision
Treatment compliance at 6 months
A compliant patient will be defined as undergoing or having completed the planned treatment agreed at the time of diagnosis or MDT discussion.
Time frame: 6 months after treatment decision
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Identification of the main drivers of treatment cost
5 most expensive items or services during colorectal cancer treatment
Time frame: 6 months after treatment decision
Colorectal cancer stage at the time of diagnosis
AJCC (American Joint Committee on Cancer) guidance - 8th edition
Time frame: At the time of colorectal cancer diagnosis (coincident with timing of patient enrolment in the study)