A nationwide audit of the use of radiotherapy for rectal cancer in Italy

Gagliardi, G.; Pucciarelli, Salvatore; Asteria, C. R.; Infantino, A.; Romano, G.; Cola, Bruno; Nardi, Paola De; Brulatti, M.; Lambertini, M.; Contessini-Avesani, Ettore; Casula, G.; Coco, Claudio; D’Amico, Davide; Selvaggi, Francesco; Eccher, Claudio; D’Ambrosio, Giovanni; Galeotti, F.; Jovine, Elio; Demma, I.; Fianchini, Aroldo; Ambrosino, Giovanni; Casentino, L. M.; Fiorino, Marina

doi:10.1007/s10151-010-0597-9

Cited by 18 publications

(9 citation statements)

References 32 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, GRT was received by: just over half of the patients with cervical cancer in NSW (2005-2011) [10]; two-thirds of patients in SA (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) with stage C colon cancer, and nearly half of stage B and C rectal cancer patients [5]; two-thirds of selected patients in NSW (2006)(2007)(2008)(2009)(2010)(2011) with Non-Small Cell Lung Cancer (NSCLC) [11,12]; and only one-third of patients in NSW with melanoma (2006)(2007) [13]. Rates of GRT have been found to be underutilised across a variety of cancers in Australia [8] and internationally [14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…CPG adherence is a good measure of quality of care, as it indicates where variation lies, and possible reasons for variation, so long as the guideline is up-to-date, and lack of adherence is interpreted carefully (i1,2,3,4,5,8,11,12,13,16,17,19,24,25,28,30)16 4 4 4CPGs provide assurance for junior clinicians (i1, 3,4, 5, 7, 8, 10, 11, 14, 15, 17, 19, 28, 33) 14 2 3 3The framework provided by CPGs is considered useful for decision making during complex cases, for unfamiliar clinical scenarios, less common cancers, or new treatments (i1, 3, 4, 5, 7, 13, 14, 16, 17, 18, 30, 32, 33) 13 1 6 2CPGs help clinicians reach consensus when there is debate over the sequence of treatment from different disciplines (i7,8,9,12,14,18,21,23,28,29,31) …”

mentioning

confidence: 99%

“…(Continued) Facilitators Easy access to guidelines (i2,3,7,9,11,12,13,15,16,17,18,19,20,21,22,23,25,28,30) …”

mentioning

confidence: 99%

“…Effective dissemination of CPGs through marketing and distribution by the CPG development group (i32), publication of CPGs in high quality journals (i2, 5, 18, 30), and dissemination and discussion regarding CPGs at conferences (i10) CPGs should include links to diet and exercise CPGs and psychosocial care recommendations (i20), links to databases to access information about the clinicians available for consultation prior to treatment (i8). CPGs should also include treatment timeframes that are realistic allowing for imaging and pathology delays (i20).Note: "I" refers to interview number; N refers to total clinicians; MO refers to Medical Oncologists (i1,3,5,6,7,8,9,15,20); RO refers to Radiation Oncologists (i2,12,18,19,21,23,27,28,29,31); S refers to Surgeons including one Gynae oncologist (i13,14,17,24,26,30,32,33); H refers to Haematologists (i4,10,11,16,22,25). https://doi.org/10.1371/journal.pone.0279116.t003…”

mentioning

confidence: 99%

See 3 more Smart Citations

Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia

et al. 2022

View full text Add to dashboard Cite

Background The burden of cancer is large in Australia, and rates of cancer Clinical Practice Guideline (CPG) adherence is suboptimal across various cancers. Methods The objective of this study is to characterise clinician-perceived barriers and facilitators to cancer CPG adherence in Australia. Semi-structured interviews were conducted to collect data from 33 oncology-focused clinicians (surgeons, radiation oncologists, medical oncologists and haematologists). Clinicians were recruited in 2019 and 2020 through purposive and snowball sampling from 7 hospitals across Sydney, Australia, and interviewed either face-to-face in hospitals or by phone. Audio recordings were transcribed verbatim, and qualitative thematic analysis of the interview data was undertaken. Human research ethics committee approval and governance approval was granted (2019/ETH11722, #52019568810127). Results Five broad themes and subthemes of key barriers and facilitators to cancer treatment CPG adherence were identified: Theme 1: CPG content; Theme 2: Individual clinician and patient factors; Theme 3: Access to, awareness of and availability of CPGs; Theme 4: Organisational and cultural factors; and Theme 5: Development and implementation factors. The most frequently reported barriers to adherence were CPGs not catering for patient complexities, being slow to be updated, patient treatment preferences, geographical challenges for patients who travel large distances to access cancer services and limited funding of CPG recommended drugs. The most frequently reported facilitators to adherence were easy accessibility, peer review, multidisciplinary engagement or MDT attendance, and transparent CPG development by trusted, multidisciplinary experts. CPGs provide a reassuring framework for clinicians to check their treatment plans against. Clinicians want cancer CPGs to be frequently updated utilising a wiki-like process, and easily accessible online via a comprehensive database, coordinated by a well-trusted development body. Conclusion Future implementation strategies of cancer CPGs in Australia should be tailored to consider these context-specific barriers and facilitators, taking into account both the content of CPGs and the communication of that content. The establishment of a centralised, comprehensive, online database, with living wiki-style cancer CPGs, coordinated by a well-funded development body, along with incorporation of recommendations into point-of-care decision support would potentially address many of the issues identified.

show abstract

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

“…(Continued) Facilitators Easy access to guidelines (i2,3,7,9,11,12,13,15,16,17,18,19,20,21,22,23,25,28,30) …”

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Etiopathogenesis of IBD relies on complex interactions between autoimmune mechanisms and environmental factors, which have not been fully understood [1] , [25] , [26] . IBD patients are at increased risk of cancer [13] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , which is a risk factor for VTE, so we sought for malignancies and excluded such patients from the analysis.…”

Section: Discussionmentioning

confidence: 99%

Hormonal contraceptives and venous thromboembolism: Are inflammatory bowel disease patients at increased risk? A retrospective study on a prospective database

Pellino

Sciaudone

Caprio

et al. 2015

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Recent studies showed an increased risk of venous thromboembolism (VTE) in patients receiving oral hormonal contraceptives. Inflammatory bowel diseases (IBD) often affect young patients and represent a pro-coagulant condition. This could result from active inflammation, but a potential role for genetic and molecular factors has been suggested. Hormonal contraceptives have also been associated with increased risk of VTE and the risk may be greater in IBD patients that already are in a pro-coagulant status, but no definitive data are available in this population. The purpose of our study was to seek for differences of the risk of VTE in IBD patients receiving hormonal contraceptives compared with controls.This is a retrospective study. We interrogated a prospectively maintained database of IBD patients observed at our outpatient clinic between 2000 and 2014. All female patients managed conservatively, with no active disease, who were taking oral hormone contraceptives in the study period, were included. Patients observed for other-than-IBD conditions at our Unit and at the Unit of Gynaecology and Obstetrics, receiving contraceptives, served as controls (ratio 1:2). Patients with cancer, those receiving hormonal therapy, and those with known genetic predisposition to VTE were excluded.We included 146 six IBD patients and 290 controls. One patient in each group developed VTE. Overall, the incidence of VTE associated with oral contraceptives was 0.5%. IBD was associated with increased risk of VTE (OR 1.9, 95% CI 0.12–32.12, p > 0.99). Active smokers since 10 years (17.2%) had higher risks of VTE (OR 8.6, 95% CI 1.16–19.25, p = 0.03).Our data show that patients with IBD in remission are not at higher risk of VTE due to oral oestrogen-containing contraceptives compared with non-IBD controls. Smokers are at increased risk, irrespective of the baseline disease.

show abstract

Rectal Cancer Radiotherapy and Older Patients: Evidence-Based or Opinion-Based Treatment?

Glynne‐Jones

Nathan

2013

Management of Colorectal Cancers in Older People

View full text Add to dashboard Cite

A nationwide audit of the use of radiotherapy for rectal cancer in Italy

Abstract: Our study first identified a treatment disparity among different geographic Italian regions. A more systematic audit is needed to confirm these results and plan adequate interventions.

Cited by 18 publications

References 32 publications

Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia

Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia

Hormonal contraceptives and venous thromboembolism: Are inflammatory bowel disease patients at increased risk? A retrospective study on a prospective database

Rectal Cancer Radiotherapy and Older Patients: Evidence-Based or Opinion-Based Treatment?

Contact Info

Product

Resources

About