Rates of adherence to cancer treatment guidelines in Australia and the factors associated with adherence: A systematic review

Mia Bierbaum; Frances Rapport; Gaston Arnolda; Yvonne Tran; Brona Nic Giolla Easpaig; Kristiana Ludlow; Robyn Clay-Williams; Elizabeth Austin; Bela Laginha; Chi Yhun Lo; Kate Churruca; Lieke van Baar; Karen Hutchinson; Renuka Chittajallu; Syeda Somyyah Owais; Ruqaiya Nullwala; Peter Hibbert; Diana Fajardo Pulido; Jeffrey Braithwaite

doi:10.1111/ajco.13948

Rates of adherence to cancer treatment guidelines in Australia and the factors associated with adherence: A systematic review

Mia Bierbaum, Frances Rapport, Gaston Arnolda, Yvonne Tran, Brona Nic Giolla Easpaig, Kristiana Ludlow, Robyn Clay-Williams, Elizabeth Austin, Bela Laginha, Chi Yhun Lo, Kate Churruca, Lieke van Baar, Karen Hutchinson, Renuka Chittajallu, Syeda Somyyah Owais, Ruqaiya Nullwala, Peter Hibbert, Diana Fajardo Pulido, Jeffrey Braithwaite

Research output: Contribution to journal › Review article › peer-review

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Abstract

Adherence to cancer treatment clinical practice guidelines (CPGs) varies enormously across Australia, despite being associated with improved patient outcomes. This systematic review aims to characterize adherence rates to active-cancer treatment CPGs in Australia and related factors to inform future implementation strategies. Five databases were systematically searched, abstracts were screened for eligibility, a full-text review and critical appraisal of eligible studies performed, and data extracted. A narrative synthesis of factors associated with adherence was conducted, and the median adherence rates within cancer streams calculated. A total of 21,031 abstracts were identified. After duplicates were removed, abstracts screened, and full texts reviewed, 20 studies focused on adherence to active-cancer treatment CPGs were included. Overall adherence rates ranged from 29% to 100%. Receipt of guideline recommended treatments was higher for patients who were younger (diffuse large B-cell lymphoma [DLBCL], colorectal, lung, and breast cancer); female (breast and lung cancer), and male (DLBCL and colorectal cancer); never smokers (DLBCL and lung cancer); non-Indigenous Australians (cervical and lung cancer); with less advanced stage disease (colorectal, lung, and cervical cancer), without comorbidities (DLBCL, colorectal, and lung cancer); with good-excellent Eastern Cooperative Oncology Group performance status (lung cancer); living in moderately accessible places (colon cancer); and; treated in metropolitan facilities (DLBLC, breast and colon cancer). This review characterized active-cancer treatment CPG adherence rates and associated factors in Australia. Future targeted CPG implementation strategies should account for these factors, to redress unwarranted variation particularly in vulnerable populations, and improve patient outcomes (Prospero number: CRD42020222962).

Original language	English
Pages (from-to)	618-644
Number of pages	27
Journal	Asia-Pacific Journal of Clinical Oncology
Volume	19
Issue number	6
DOIs	https://doi.org/10.1111/ajco.13948
Publication status	Published - Dec 2023
Externally published	Yes

Bibliographical note

Funding Information:
The authors would like to thank the librarian (Mary Simons) for their support in developing the database search strategy. This work was supported by an Australian Government's Research Training Program Scholarship, associated with the Australian Institute of Health Innovation, Macquarie University, Grant Number ID: 9100002 awarded to MB. Open access publishing facilitated by Macquarie University, as part of the Wiley - Macquarie University agreement via the Council of Australian University Librarians.

Funding Information:
The authors would like to thank the librarian (Mary Simons) for their support in developing the database search strategy. This work was supported by an Australian Government's Research Training Program Scholarship, associated with the Australian Institute of Health Innovation, Macquarie University, Grant Number ID: 9100002 awarded to MB.

Publisher Copyright:
© 2023 The Authors. Asia-Pacific Journal of Clinical Oncology published by John Wiley & Sons Australia, Ltd.

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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77137256-oaFinal published version, 791 KBLicence: CC BY

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Bierbaum, M., Rapport, F., Arnolda, G., Tran, Y., Nic Giolla Easpaig, B., Ludlow, K., Clay-Williams, R., Austin, E., Laginha, B., Lo, C. Y., Churruca, K., van Baar, L., Hutchinson, K., Chittajallu, R., Owais, S. S., Nullwala, R., Hibbert, P., Fajardo Pulido, D., & Braithwaite, J. (2023). Rates of adherence to cancer treatment guidelines in Australia and the factors associated with adherence: A systematic review. Asia-Pacific Journal of Clinical Oncology, 19(6), 618-644. https://doi.org/10.1111/ajco.13948

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title = "Rates of adherence to cancer treatment guidelines in Australia and the factors associated with adherence: A systematic review",

abstract = "Adherence to cancer treatment clinical practice guidelines (CPGs) varies enormously across Australia, despite being associated with improved patient outcomes. This systematic review aims to characterize adherence rates to active-cancer treatment CPGs in Australia and related factors to inform future implementation strategies. Five databases were systematically searched, abstracts were screened for eligibility, a full-text review and critical appraisal of eligible studies performed, and data extracted. A narrative synthesis of factors associated with adherence was conducted, and the median adherence rates within cancer streams calculated. A total of 21,031 abstracts were identified. After duplicates were removed, abstracts screened, and full texts reviewed, 20 studies focused on adherence to active-cancer treatment CPGs were included. Overall adherence rates ranged from 29% to 100%. Receipt of guideline recommended treatments was higher for patients who were younger (diffuse large B-cell lymphoma [DLBCL], colorectal, lung, and breast cancer); female (breast and lung cancer), and male (DLBCL and colorectal cancer); never smokers (DLBCL and lung cancer); non-Indigenous Australians (cervical and lung cancer); with less advanced stage disease (colorectal, lung, and cervical cancer), without comorbidities (DLBCL, colorectal, and lung cancer); with good-excellent Eastern Cooperative Oncology Group performance status (lung cancer); living in moderately accessible places (colon cancer); and; treated in metropolitan facilities (DLBLC, breast and colon cancer). This review characterized active-cancer treatment CPG adherence rates and associated factors in Australia. Future targeted CPG implementation strategies should account for these factors, to redress unwarranted variation particularly in vulnerable populations, and improve patient outcomes (Prospero number: CRD42020222962).",

keywords = "guideline adherence, medical oncology, practice guideline, radiation oncology, surgical oncology",

author = "Mia Bierbaum and Frances Rapport and Gaston Arnolda and Yvonne Tran and {Nic Giolla Easpaig}, Brona and Kristiana Ludlow and Robyn Clay-Williams and Elizabeth Austin and Bela Laginha and Lo, {Chi Yhun} and Kate Churruca and {van Baar}, Lieke and Karen Hutchinson and Renuka Chittajallu and Owais, {Syeda Somyyah} and Ruqaiya Nullwala and Peter Hibbert and {Fajardo Pulido}, Diana and Jeffrey Braithwaite",

note = "Funding Information: The authors would like to thank the librarian (Mary Simons) for their support in developing the database search strategy. This work was supported by an Australian Government's Research Training Program Scholarship, associated with the Australian Institute of Health Innovation, Macquarie University, Grant Number ID: 9100002 awarded to MB. Open access publishing facilitated by Macquarie University, as part of the Wiley - Macquarie University agreement via the Council of Australian University Librarians. Funding Information: The authors would like to thank the librarian (Mary Simons) for their support in developing the database search strategy. This work was supported by an Australian Government's Research Training Program Scholarship, associated with the Australian Institute of Health Innovation, Macquarie University, Grant Number ID: 9100002 awarded to MB. Publisher Copyright: {\textcopyright} 2023 The Authors. Asia-Pacific Journal of Clinical Oncology published by John Wiley & Sons Australia, Ltd.",

year = "2023",

month = dec,

doi = "10.1111/ajco.13948",

language = "English",

volume = "19",

pages = "618--644",

journal = "Asia-Pacific Journal of Clinical Oncology",

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Bierbaum, M, Rapport, F, Arnolda, G, Tran, Y, Nic Giolla Easpaig, B, Ludlow, K, Clay-Williams, R, Austin, E, Laginha, B, Lo, CY, Churruca, K, van Baar, L, Hutchinson, K, Chittajallu, R, Owais, SS, Nullwala, R, Hibbert, P, Fajardo Pulido, D & Braithwaite, J 2023, 'Rates of adherence to cancer treatment guidelines in Australia and the factors associated with adherence: A systematic review', Asia-Pacific Journal of Clinical Oncology, vol. 19, no. 6, pp. 618-644. https://doi.org/10.1111/ajco.13948

TY - JOUR

T1 - Rates of adherence to cancer treatment guidelines in Australia and the factors associated with adherence

T2 - A systematic review

AU - Bierbaum, Mia

AU - Rapport, Frances

AU - Arnolda, Gaston

AU - Tran, Yvonne

AU - Nic Giolla Easpaig, Brona

AU - Ludlow, Kristiana

AU - Clay-Williams, Robyn

AU - Austin, Elizabeth

AU - Laginha, Bela

AU - Lo, Chi Yhun

AU - Churruca, Kate

AU - van Baar, Lieke

AU - Hutchinson, Karen

AU - Chittajallu, Renuka

AU - Owais, Syeda Somyyah

AU - Nullwala, Ruqaiya

AU - Hibbert, Peter

AU - Fajardo Pulido, Diana

AU - Braithwaite, Jeffrey

N1 - Funding Information: The authors would like to thank the librarian (Mary Simons) for their support in developing the database search strategy. This work was supported by an Australian Government's Research Training Program Scholarship, associated with the Australian Institute of Health Innovation, Macquarie University, Grant Number ID: 9100002 awarded to MB. Open access publishing facilitated by Macquarie University, as part of the Wiley - Macquarie University agreement via the Council of Australian University Librarians. Funding Information: The authors would like to thank the librarian (Mary Simons) for their support in developing the database search strategy. This work was supported by an Australian Government's Research Training Program Scholarship, associated with the Australian Institute of Health Innovation, Macquarie University, Grant Number ID: 9100002 awarded to MB. Publisher Copyright: © 2023 The Authors. Asia-Pacific Journal of Clinical Oncology published by John Wiley & Sons Australia, Ltd.

PY - 2023/12

Y1 - 2023/12

N2 - Adherence to cancer treatment clinical practice guidelines (CPGs) varies enormously across Australia, despite being associated with improved patient outcomes. This systematic review aims to characterize adherence rates to active-cancer treatment CPGs in Australia and related factors to inform future implementation strategies. Five databases were systematically searched, abstracts were screened for eligibility, a full-text review and critical appraisal of eligible studies performed, and data extracted. A narrative synthesis of factors associated with adherence was conducted, and the median adherence rates within cancer streams calculated. A total of 21,031 abstracts were identified. After duplicates were removed, abstracts screened, and full texts reviewed, 20 studies focused on adherence to active-cancer treatment CPGs were included. Overall adherence rates ranged from 29% to 100%. Receipt of guideline recommended treatments was higher for patients who were younger (diffuse large B-cell lymphoma [DLBCL], colorectal, lung, and breast cancer); female (breast and lung cancer), and male (DLBCL and colorectal cancer); never smokers (DLBCL and lung cancer); non-Indigenous Australians (cervical and lung cancer); with less advanced stage disease (colorectal, lung, and cervical cancer), without comorbidities (DLBCL, colorectal, and lung cancer); with good-excellent Eastern Cooperative Oncology Group performance status (lung cancer); living in moderately accessible places (colon cancer); and; treated in metropolitan facilities (DLBLC, breast and colon cancer). This review characterized active-cancer treatment CPG adherence rates and associated factors in Australia. Future targeted CPG implementation strategies should account for these factors, to redress unwarranted variation particularly in vulnerable populations, and improve patient outcomes (Prospero number: CRD42020222962).

AB - Adherence to cancer treatment clinical practice guidelines (CPGs) varies enormously across Australia, despite being associated with improved patient outcomes. This systematic review aims to characterize adherence rates to active-cancer treatment CPGs in Australia and related factors to inform future implementation strategies. Five databases were systematically searched, abstracts were screened for eligibility, a full-text review and critical appraisal of eligible studies performed, and data extracted. A narrative synthesis of factors associated with adherence was conducted, and the median adherence rates within cancer streams calculated. A total of 21,031 abstracts were identified. After duplicates were removed, abstracts screened, and full texts reviewed, 20 studies focused on adherence to active-cancer treatment CPGs were included. Overall adherence rates ranged from 29% to 100%. Receipt of guideline recommended treatments was higher for patients who were younger (diffuse large B-cell lymphoma [DLBCL], colorectal, lung, and breast cancer); female (breast and lung cancer), and male (DLBCL and colorectal cancer); never smokers (DLBCL and lung cancer); non-Indigenous Australians (cervical and lung cancer); with less advanced stage disease (colorectal, lung, and cervical cancer), without comorbidities (DLBCL, colorectal, and lung cancer); with good-excellent Eastern Cooperative Oncology Group performance status (lung cancer); living in moderately accessible places (colon cancer); and; treated in metropolitan facilities (DLBLC, breast and colon cancer). This review characterized active-cancer treatment CPG adherence rates and associated factors in Australia. Future targeted CPG implementation strategies should account for these factors, to redress unwarranted variation particularly in vulnerable populations, and improve patient outcomes (Prospero number: CRD42020222962).

KW - guideline adherence

KW - medical oncology

KW - practice guideline

KW - radiation oncology

KW - surgical oncology

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DO - 10.1111/ajco.13948

M3 - Review article

AN - SCOPUS:85150377050

SN - 1743-7555

VL - 19

SP - 618

EP - 644

JO - Asia-Pacific Journal of Clinical Oncology

JF - Asia-Pacific Journal of Clinical Oncology

IS - 6

ER -

Rates of adherence to cancer treatment guidelines in Australia and the factors associated with adherence: A systematic review

Abstract

Bibliographical note

UN SDGs

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