Implementing a clinical pathway for quality-of-life diagnostics and therapy in follow-up of breast cancer patients

758 Background: In order to integrate DRQL diagnostics into the guideline-based treatment of breast cancer patients a logistically refined clinical pathway was developed and implemented in the regional tumor center (population 2,3 millions) to diagnose and treat DRQL in breast cancer patients. Methods: Implementation from June 2003- Sept. 2004 included a prospective trial with 218 female patients (age 34–86 years), a multifaceted strategy (outreach visits, opinion leaders, CME in a quality circle) (Med Care 39, Suppl. 2, 85, 2000). The clinical pathway has been developed using the clinical algorithm methodology (Med. Dec. Mak. 12, 149,1992) and is here presented in narrative terms. Results: The clinical pathway starts in the clinic with DRQL questionnaire and health status by the physician. They are sent to the quality of life unit for producing the visual QL profiles and the expert report. The letter is sent to coordinating practitioners who decide either not to accept or to apply one or more of 5 therap...