Impact of case management on chemotherapy adherence, complications, and quality of life post-bladder tumor resection

Successful management of non-muscle-invasive bladder cancer (NMIBC) following transurethral resection of bladder tumor (TURBT) depends critically on compliance with intravesical chemotherapy. This study evaluates the impact of a case management model on patient adherence and prognosis. This retrospective cohort analysis enrolled NMIBC patients who underwent intravesical chemotherapy after TURBT from June 2022 to June 2024. Subjects were allocated to either a case management cohort (n = 47) or a conventional care cohort (n = 43). Evaluations conducted at 6 and 12 months post-intervention encompassed adherence to therapy, scores from the Functional Assessment of Cancer Therapy – Bladder (FACT-BL), incidence of complications, rates of bladder tumor recurrence, results from the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), as well as outcomes from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BLS24). The case management group showed higher overall treatment adherence (100 % vs 83.72 %, p = 0.013), calculated for all 47 patients who completed the one-year study period with no dropouts or exclusions due to protocol deviation, and lower complication rates during instillation (21.28 % vs 46.51 %, p = 0.011). FACT-BL scores in all four domains were higher in the case management group (all p < 0.05). SAS (41.77 vs 49.32, p < 0.001) and SDS (44.66 vs 47.82, p = 0.001) scores were lower. QLQ-BLS24 indicated reduced future concerns and improved gastrointestinal symptoms, while QLQ-C30 showed better cognitive, emotional, and social functioning. No difference in bladder tumor recurrence rates was observed (p > 0.05). A structured case management model enhanced adherence, reduced complications, and improved quality of life for NMIBC patients receiving intravesical chemotherapy without negatively impacting short-term recurrence rates.