Adherence to Quality Indicators and Survival in Patients With Breast Cancer

Cheng, Skye Hung-Chun; Wang, C Jason; Jinlong, Lin; Horng, Cheng-Fang; Lu, Ming‐Chi; Asch, Steven M.; Hilborne, Lee H.; Liu, Mei-Ching; Chen, Chii‐Ming; Huang, Andrew T.

doi:10.1097/mlr.0b013e3181893c4a

Cited by 69 publications

(67 citation statements)

References 35 publications

(33 reference statements)

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“…These treatment recommendations are well studied and universally accepted to have a direct benefit of health outcomes and yet are least likely to be received by the population targeted by the national PNRP. 36 Although we are able to report a positive association between navigation and receipt of antiestrogen therapy, our study cannot elucidate the process or mechanism behind how patient navigation may be effective. Questions remain regarding the specific tasks or barriers addressed that may have helped to facilitate treatment.…”

Section: Discussionmentioning

confidence: 69%

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

Darnell²,

Calhoun³

et al. 2014

JCO

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Purpose Poor and underserved women face barriers in receiving timely and appropriate breast cancer care. Patient navigators help individuals overcome these barriers, but little is known about whether patient navigation improves quality of care. The purpose of this study is to examine whether navigated women with breast cancer are more likely to receive recommended standard breast cancer care. Patients and Methods Women with breast cancer who participated in the national Patient Navigation Research Program were examined to determine whether the care they received included the following: initiation of antiestrogen therapy in patients with hormone receptor–positive breast cancer; initiation of postlumpectomy radiation therapy; and initiation of chemotherapy in women younger than age 70 years with triple-negative tumors more than 1 cm. This is a secondary analysis of a multicenter quasi-experimental study funded by the National Cancer Institute to evaluate patient navigation. Multiple logistic regression was performed to compare differences in receipt of care between navigated and non-navigated participants. Results Among participants eligible for antiestrogen therapy, navigated participants (n = 380) had a statistically significant higher likelihood of receiving antiestrogen therapy compared with non-navigated controls (n = 381; odds ratio [OR], 1.73; P = .004) in a multivariable analysis. Among the participants eligible for radiation therapy after lumpectomy, navigated participants (n = 255) were no more likely to receive radiation (OR, 1.42; P = .22) than control participants (n = 297). Conclusion We demonstrate that navigated participants were more likely than non-navigated participants to receive antiestrogen therapy. Future studies are required to determine the full impact patient navigation may have on ensuring that vulnerable populations receive quality care.

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Section: Discussionmentioning

confidence: 69%

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

Darnell²,

Calhoun³

et al. 2014

JCO

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“…It has been shown previously that patients who were treated in agreement with the guidelines had a longer disease-free and overall survival, in comparison to patients treated in a ‘non-guideline-conforming' way [27,28,29]. Wöckel et al [30] described a 5-year recurrence-free survival and overall survival rate of 90.1% and 92.4%, respectively, in patients receiving guideline-conforming therapy and of 80.1% and 76.0%, respectively, in patients receiving non-guideline-conforming therapy.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Early Breast Cancer Treated in an Urban and a Rural Breast Cancer Unit in Germany

Heitz

Bender²,

Barinoff³

et al. 2013

Oncol Res Treat

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Background: Conflicting evidence has been published concerning survival disadvantages in the outcome of breast cancer patients in relationship to their residency in urban or rural communities. Methods: The primary aim of this study was to evaluate differences in patients and treatment characteristics between an urban and a rural breast cancer unit. Therefore, all early breast cancer patients treated consecutively between 1999 and 2007 in a rural and an urban breast cancer unit were included. Patient and tumor characteristics, treatment strategies, and guideline adherence were included to evaluate the prognoses of both populations. Results: Overall, data from 2,566 patients were included in this analysis. The 610 patients treated in the rural unit showed significantly more negative prognostic criteria than the 1,956 patients treated in the urban center. No differences were observed with respect to surgical and systemic treatment after adjustment for prognostic parameters. Adherence to national guidelines did not differ significantly between both settings and ranged between 78.0 and 95.6%. Furthermore, no differences regarding recurrence-free and overall survival were observed. Conclusions: The stage-adjusted pattern of care was similar in 2 German breast care units in a rural region and an urban area. Nevertheless, an earlier diagnosis of breast cancer should be enforced in rural areas to avoid extended treatment burden.

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“…En cáncer de mama, aunque existen criterios estandarizados de tratamiento, basados en la evidencia y difundidos por las sociedades científicas, el 15% de las pacientes en Estados Unidos y un porcentaje no evaluado en nuestro país no recibe el tratamiento sugerido que es el que según la evidencia, tiene los mejores resultados 1 . La evaluación de la calidad de las prestaciones de salud ha cobrado importancia en los últimos años por varias razones.…”

Section: Introductionunclassified

Indicadores de calidad en cáncer de mama

R¹,

C²,

M³

et al. 2013

Rev Chil Cir

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The use of quality indicators allows breast cancer surgery result evaluation, enabling comparison between centers and established standards, giving objective and reproducible information, helpful to plan process optimization. These or similar indicators are useful in all breast cancer treatment steps and for breast cancer unit accreditation processes. Our indicator values that are under the standard reveal that some specific local indicators are required.

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Adherence to Quality Indicators and Survival in Patients With Breast Cancer

Abstract: Our study strongly supports that 100% adherence to evidence supported quality-of-care indicators is associated with better survival rates for breast cancer patients and should be a priority for practitioners.

Cited by 69 publications

References 35 publications

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

Outcome of Early Breast Cancer Treated in an Urban and a Rural Breast Cancer Unit in Germany

Indicadores de calidad en cáncer de mama

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