Use of guideline‐recommended adjuvant therapies and survival outcomes for people with colorectal cancer at tertiary referral hospitals in South Australia

Adelson, Pamela; Fusco, Kellie; Karapetis, Christos S.; Wattchow, David; Joshi, Rohit; Price, Tim; Sharplin, Greg; Roder, David

doi:10.1111/jep.12757

Cited by 16 publications

(39 citation statements)

References 25 publications

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“…Despite this state of knowledge, there is currently a gap regarding the synthesis of clinicians' views around adherence to active cancer treatment CPGs, and the associated barriers and facilitators to CPG adherence. There is evidence that levels of adherence across a variety of cancer treatment CPGs is relatively low [23][24][25][31][32][33][34][35][36][37][38]. It is important to examine the reasons behind this, with a view to identifying potential improvements in design and content of CPGs, or their dissemination.…”

Section: Negative Attitudes Toward Cpgs Also Constitute Important Barmentioning

confidence: 99%

“…It is important to examine the reasons behind this, with a view to identifying potential improvements in design and content of CPGs, or their dissemination. There is evidence that CPGadherent treatments for an array of cancers are associated with higher survival rates [33,[39][40][41][42]; however, while CPG adherence is often used as a measure of quality of care, a lack of adherence does not necessarily represent suboptimal care, if there is reasonable justification for variation [43].…”

Section: Negative Attitudes Toward Cpgs Also Constitute Important Barmentioning

confidence: 99%

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Clinicians’ attitudes and perceived barriers and facilitators to cancer treatment clinical practice guideline adherence: a systematic review of qualitative and quantitative literature

et al. 2020

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Background: Clinical Practice Guidelines (CPGs) synthesize the best available evidence to guide clinician and patient decision making. There are a multitude of barriers and facilitators to clinicians adhering to CPGs; however, little is known about active cancer treatment CPG adherence specifically. This systematic review sought to identify clinician attitudes, and perceived barriers and facilitators to active cancer treatment CPG adherence. Methods: A systematic search was undertaken of five databases; Ovid Medline, PsychInfo, Embase, Scopus, CINAHL, and PROQUEST. The retrieved abstracts were screened for eligibility against inclusion criteria, and a full text review was conducted of all eligible studies. Data were extracted, and a quality assessment was conducted of all included studies. The qualitative papers were thematically analyzed. Attitudes, barriers, and facilitating factors extracted from the quantitative papers were categorized within the qualitative thematic framework. Results: The search resulted in the identification of 9676 titles. After duplicates were removed, abstracts screened, and full texts reviewed, 15 studies were included. Four themes were identified which related to negative clinician attitudes and barriers to active cancer treatment CPG adherence: (1) concern over CPG content and currency of CPGs; (2) concern about the evidence underpinning CPGs; (3) clinician uncertainty and negative perceptions of CPGs; and (4) organizational and patient factors. The review also identified four themes related to positive attitudes and facilitators to active cancer treatment CPG adherence: (5) CPG accessibility and ease of use; (6) endorsement and dissemination of CPGs and adequate access to treatment facilities and resources; (7) awareness of CPGs and belief in their relevance; and (8) belief that CPGs support decision making, improve patient care, reduce clinical variation, and reduce costs.

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Section: Negative Attitudes Toward Cpgs Also Constitute Important Barmentioning

confidence: 99%

Section: Negative Attitudes Toward Cpgs Also Constitute Important Barmentioning

confidence: 99%

Clinicians’ attitudes and perceived barriers and facilitators to cancer treatment clinical practice guideline adherence: a systematic review of qualitative and quantitative literature

et al. 2020

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“…Enhanced implementation may lead to increased CPG adherence, which has been found to be associated with improved patient survival, in some cancers. [4][5][6] No patients were involved in the design of this study.…”

Section: Phase 3: Workhopmentioning

confidence: 99%

“…3 There is evidence that some CPG-adherent cancer treatments are associated with higher survival rates, compared with CPG non-adherent treatment. [4][5][6][7][8] For example, in a South Australian study, stage C colon cancer patients who received CPG adherent treatment between 2000 and 2010 were found to have a higher 5-year survival (71.2%) than those who did not (53.2%), 5 although selection bias can be a limitation in these types of studies if comorbidity is not controlled for.…”

Section: Introductionmentioning

confidence: 99%

Clinicians’ attitudes to oncology clinical practice guidelines and the barriers and facilitators to adherence: a mixed methods study protocol

et al. 2020

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IntroductionClinical practice guidelines (CPGs) are designed to reduce inappropriate clinical variation and improve the quality of care. Barriers to CPGs include a lack of awareness of CPGs, access to them, time pressures and concerns regarding the evidence underpinning CPG development, implementation and dissemination. The objectives of this study are to assess clinicians’ attitudes to CPGs for cancer treatment and the perceived barriers to and facilitators of CPG adherence in order to inform the implementation of cancer treatment CPGs.Methods and analysisA mixed methods study will be conducted using a three-phase, sequential design, with each phase informing the next. In phase 1, a qualitative study using recorded interviews will investigate clinicians’ attitudes to CPGs for cancer treatment and perceptions of barriers and facilitators to CPG adherence (n=30); interview transcripts will be analysed thematically. In phase 2, a survey will quantify the frequency of attitudes, barriers and facilitators identified in phase 1, in a broader clinical sample (n=200). In phase 3, a workshop forum will be held to facilitate discussions examining the implications of phase 1 and 2 findings for cancer CPG implementation strategies (n=40) leading to recommendations for improvements to practice. The workshop discussion will be recorded, and the transcript will be analysed thematically.Ethics and disseminationThis study has received ethics approval in New South Wales, Australia (2019/ETH11722, #52019568810127). Study findings will be published in peer-reviewed journals and will form part of a doctoral thesis and be presented at national and international conferences.

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“…Further study on CRC patients in respect to change in immunological microenvironment with origin as well as the prognosis of cancer is a one of the significant methods for early detection of biomarkers as well as identifying the target for immunotherapy. It is well studied that the first‐tier treatment of colorectal cancer is timely surgical interventions or total colectomy (Adelson et al, ). Hence, different anesthesia pattern would have a significant role for the prognosis of colorectal cancer.…”

Section: Introductionmentioning

confidence: 99%

A comprehensive study of immunology repertoires in both preoperative stage and postoperative stage in patients with colorectal cancer

Liu

Cui

Zhang

et al. 2019

Molec Gen & Gen Med

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Background Colorectal cancer (CRC) is the 3rd most common cancer type in the world. The correlation between immune repertoire and prognosis of CRC has been well studied in the last decades. The diversity and stability of the immune cells can be measured by hypervariable complementarity‐determining region 3 (CDR3) segments of the T‐cell receptor (TCR). Methods In this study, we collected five healthy controls and 19 CRC patients’ peripheral blood mononuclear cells (PBMCs) in three stages, namely 1 day preoperative, 3 days’ postoperative, and 7 days’ postoperative, respectively. Simultaneously, we have also done the comparative analysis of these two different anesthesia methods, namely TIVA and CEGA. Sequencing of the TCR segments has been performed by multiplex PCR and high‐throughput next‐generation sequencing. We also analyzed the distribution of CDR3 length, highly expansion clones (HECs), TRBV, and TRBJ gene usage. Results Our result showed a significant difference between TCR CDR3 length distribution and HEC distribution between CRC patients and healthy controls. We also found that TRBV11‐2, TRBV12‐1, TRBV16, TRBV3‐2, TRBV4‐2, TRBV4‐3, TRBV5‐4, TRBV6‐8, TRBV7‐8, TRBV7‐9 and RBV11‐2, TRBV12‐1, TRBV16, TRBV3‐2, TRBV4‐2, TRBV4‐3, TRBV5‐4, TRBV6‐8, TRBV7‐8, and TRBV7‐9 usages are different between CRC patients and healthy controls. Conclusion In conclusion, CRC patients were presented with different immune repertoire in comparison with healthy controls. In this study, significant difference in TRBV and TRBJ gene usage in between case and control group could provide some potential biomarker for the diagnosis and the treatment of the patients with CRC.

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Use of guideline‐recommended adjuvant therapies and survival outcomes for people with colorectal cancer at tertiary referral hospitals in South Australia

Cited by 16 publications

References 25 publications

Clinicians’ attitudes and perceived barriers and facilitators to cancer treatment clinical practice guideline adherence: a systematic review of qualitative and quantitative literature

Clinicians’ attitudes and perceived barriers and facilitators to cancer treatment clinical practice guideline adherence: a systematic review of qualitative and quantitative literature

Clinicians’ attitudes to oncology clinical practice guidelines and the barriers and facilitators to adherence: a mixed methods study protocol

A comprehensive study of immunology repertoires in both preoperative stage and postoperative stage in patients with colorectal cancer

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