Bibliografias temáticas / Guideline-concordant care

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Literatura científica selecionada sobre o tema "Guideline-concordant care"

Autor: Grafiati
Publicado: 4 de junho de 2021
Última modificação: 11 de fevereiro de 2022

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Artigos de revistas sobre o assunto "Guideline-concordant care"

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Ju, Michelle, James-Michael Blackwell, Patricio Polanco, John C. Mansour, Sam C. Wang, Matthew R. Porembka, Herbert Zeh e Adam Charles Yopp. "Affordable Care Act Medicaid expansion does not reduce guideline concordant cancer care disparities in vulnerable populations." Journal of Clinical Oncology 38, n.º 15_suppl (20 de maio de 2020): 2039. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.2039.

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2039 Background: The receipt of timely, guideline concordant cancer amongst racial/ethnic and socioeconomic vulnerable populations remains a significant health policy issue. The Affordable Care Act (ACA) with implementation of Medicaid Expansion sought to reduce cancer disparities by reducing uninsured rates, theoretically improving healthcare access and delivery. We assessed the impact of Medicaid expansion on racial/ethnic disparities in the receipt of timely guideline concordant cancer care. Methods: We identified patients between 40-64 years of age with all stages of cancer (lung, colorectal, breast, uterine, and cervical) in the National Cancer Database, 2012-2015. Patients were assigned to Medicaid expansion cohort based on state of residence and whether Medicaid expansion was enacted at date of diagnosis in that state. Guideline concordant care was defined based on NCCN guidelines. We constructed an ecological model with multivariate regression analysis on rate of guideline concordant care receipt with covariates including race/ethnicity, Medicaid expansion, SES, gender, Charlson-Deyo score, and treatment facility type. Results: We identified 445,952 patients, 12% Black, 6% Hispanic white, median age 55 years. Patients in the lowest SES quartile following Medicaid expansion had the greatest increase in rates of insured status, although all SES quartiles had increased insured rates compared to non-Medicaid expansion regardless of race/ethnicity. In our ecological model, the rate of receipt of guideline concordant care declined by 0.5% per year between 2012-2015. After adjusting for covariates, Asians were 2.8% less likely to receive guideline concordant care than non-Hispanic whites, Blacks 3.8% less likely, and Hispanics 6.3% less likely (p < 0.0001). Racial/ethnic disparities in receipt of guideline concordant cancer care remained after Medicaid expansion with no differential benefit. Conclusions: Insurance gains under the ACA Medicaid expansion did not affect the rate of guideline concordant care receipt. Significant racial disparities persist in the likelihood of receiving guideline concordant care, particularly among Hispanics. Further studies are needed to determine additional barriers to cancer care access/delivery and identify key targets aimed at improving equity.
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Vyas, Ami M., Hilary Aroke e Stephen J. Kogut. "HSR19-111: Disparities in Guideline-Concordant Care Among HER2 Positive Metastatic Breast Cancer Patients". Journal of the National Comprehensive Cancer Network 17, n.º 3.5 (8 de março de 2019): HSR19–111. http://dx.doi.org/10.6004/jnccn.2018.7196.

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Background: We examined guideline-concordant care among women with HER2+ MBC and determined the magnitude of differences in guideline-concordant care between those with positive and negative hormone receptor (HR) status by utilizing a non-linear decomposition technique. Methods: We conducted a retrospective observational cohort study using the Surveillance, Epidemiology, End Results-Medicare linked database. The study cohort consisted of women age >66 years diagnosed with HER2+ MBC in 2010–2013 (N=241). Guideline-concordant initial care within 6 months of cancer diagnosis was defined as per NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). A multivariate logistic regression was performed to identify the significant predictors of guideline-concordant care. A post-regression non-linear decomposition was conducted to examine the magnitude of disparities in guideline concordant care by women’s HR status. Results: 76.8% of the study cohort received guideline-concordant care, while 23.2% did not. As compared to those who did not receive guideline-concordant care, women who received guideline-concordant care were significantly more likely to have positive HR status (adjusted odds ratio (AOR)=2.11; P=.04), had good performance status (AOR=3.46; P=.0008), and had a higher number of oncology visits (AOR=8.05; P<.0001). With 1 year increase in age at cancer diagnosis, there was 5% lesser likelihood of receiving guideline-concordant care (AOR=0.95; P=.04). From the decomposition analysis, 19.0% of the disparity in guideline-concordant care between women with positive and negative HR status was explained by differences in their characteristics. Enabling characteristics (marital status, census-level income, and education) explained the highest (22.8%) proportion of the disparity, followed by external environmental factors (location of residence, SEER region, hospitals offering oncology services) at 5.3%, and need-related factors (tumor grade, comorbidity, performance status, number of metastases) at 3.2%. Conclusion: Almost one quarter of the study cohort did not receive guideline-concordant care. There are opportunities to improve cancer care for women with negative HR status who have lower socioeconomic status. The high unexplained portion of differences in guideline-concordant care (81.0%) can be due to patient preferences for treatment, propensity to seek care, and organizational and physician-level factors not captured in the database.
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Kimmick, Gretchen Genevieve, Steven Fleming, Susan A. Sabatino, Xiao-cheng Wu, Wenke Hwang, J. Frank Wilson, Mary Jo B. Lund, Rosemary Cress e Roger T. Anderson. "Influence of comorbidity on guideline concordant care for breast cancer: Findings from the Center for Disease Control and Prevention National Program of Cancer Registry (NPCR) patterns of care study." Journal of Clinical Oncology 30, n.º 15_suppl (20 de maio de 2012): 6052. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.6052.

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6052 Background: Comorbidity burden predicts cancer treatment and may influence outcome. We explore the relationship of specific comorbid illnesses with receipt of guideline concordant care for early stage breast cancer. Methods: The NPCR’s Patterns of Care study reabstracted the medical records of breast cancer cases diagnosed in 2004 from 7 cancer registries. We included women with nonmetastatic in situ and invasive breast cancer, known hormone receptor status, node status, and tumor size. Guideline-concordant management, including surgery, radiation, chemotherapy and endocrine components, was based on NCCN guidelines using tumor size, nodal and hormone receptor status. Comorbidity was measured according to the Adult Comorbidity Evaluation Index (ACE). Multivariate logistic regression models were used to determine factors associated with guideline-concordant care, and included overall ACE scores and 26 separate ACE comorbidity categories, as well as age, race, hormone receptor status, and HER2 status. Results: The study sample included 6904 women (mean age 58.7 and range 20-99 years, 76% white, 45% with ACE comorbidity score of 0, 70% ER and/or PR+, 13% HER2+). Overall, 64% received guideline-concordant care. Receipt of guideline-concordant care varied by overall comorbidity burden (71% for none; 65% for minor; 63% for moderate; 50% for severe; p<0.05). The presence of hypertension (OR 1.26, 95% CI 1.08-1.48) predicted receipt of guideline concordant care, whereas, peripheral artery disease (OR 0.44, 95% CI 0.21-0.93), diabetes (OR 0.78, 95% CI 0.63-0.97) and dementia (OR 0.31, 95% CI 0.13-0.74) predicted lack of guideline concordant care. Older age, black race, and hormone receptor positivity were associated with less, and HER2 positivity with receipt of more guideline-concordant care. Conclusions: Overall those with more comorbidity burden received less guideline-concordant care. However, the effects vary by specific conditions. The odds of receiving guideline-concordant care was greater in those with hypertension and less in those with peripheral arterial disease, diabetes, and dementia.
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Fang, P., W. He, S. Giordano e G. L. Smith. "Racial Disparities in Guideline-Concordant Cancer Care". International Journal of Radiation Oncology*Biology*Physics 99, n.º 2 (outubro de 2017): S10. http://dx.doi.org/10.1016/j.ijrobp.2017.06.039.

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Machhi, Rushad, e Amanda Marie Parkes. "Impact of psychosocial factors on the receipt of guideline concordant care in adolescent and young adults with localized Ewing sarcoma and osteosarcoma." Journal of Clinical Oncology 39, n.º 15_suppl (20 de maio de 2021): e18658-e18658. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e18658.

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e18658 Background: Adolescent and young adults (AYAs) experience poorer outcomes, including lower survival improvements, compared to younger and older patients. As higher compliance with National Comprehensive Cancer Network (NCCN) guidelines has been associated with improved outcomes, we sought to understand the influence of psychosocial factors on receipt of care concordant with NCCN guidelines in AYAs with bone sarcomas. Methods: Retrospective chart review was performed on adult AYA patients (18-39 years) with localized Ewing sarcoma (ES) or high-grade conventional osteosarcoma (OS) seen at least once between 2015-2019 at the University of Wisconsin (UW). These tumor types were selected given uniform guideline-based care recommendations. Chart review identified receipt of standard care as per NCCN Bone Cancer guidelines, defined as neoadjuvant chemotherapy, local therapy (surgery/radiation), and adjuvant chemotherapy with receipt of at least 75% of recommended chemotherapy cycles, and compared to interpersonal relationships (marital status and presence of children at cancer diagnosis), changes in school or work following cancer diagnosis, substance use, and residential location. Results: We identified 21 AYA patients with localized ES (10/21, 48%) or OS (11/21, 52%), with 67% (14/21) receiving NCCN guideline concordant care. Receipt of guideline concordant care was associated with interpersonal relationships, with only 33% (1/3) of patients with children versus 72% (13/18) of patients without children receiving guideline concordant care. Additionally, the one patient noted to divorce following cancer diagnosis did not receive guideline concordant care (0/1, 0%) as compared with 67% (10/15) of single patients and 80% (4/5) of married patients. Vocational changes also affected care, with only 56% (5/9) of patients with work change following cancer diagnosis receiving guideline concordant care versus 75% (9/12) without work changes. Guideline concordant care was less common in patients with alcohol use (5/10, 50%) as compared with patients without alcohol use (9/11, 82%). Residential distance to UW was also associated with receipt of guideline concordant care, which was more common in patients living 0-20 miles from UW (86%, 6/7) as compared with those 21-100 miles from UW (60%, 6/10) or > 100 miles from UW (50%, 2/4). Conclusions: Given the occurrence of cancer during a complex developmental time, AYAs have a relatively high occurrence of psychosocial changes and needs, which we found to be associated with receipt of NCCN guideline concordant care in patients with localized ES and OS. While a limited sample size, as the first study to define specific psychosocial factors that affect receipt of guideline concordant care, these finding suggest the need to improve identification and support of these discrete patient factors.
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Clair, Kiran, Jenny Chang, Argyrios Ziogas, Sora Park Tanjasiri, Kari Joanne Kansal, Greg E. Gin, Jason A. Zell e Robert E. Bristow. "Disparities by race, socioeconomic status, and insurance type in the receipt of NCCN guideline concordant care for select cancer types in California." Journal of Clinical Oncology 38, n.º 15_suppl (20 de maio de 2020): 7031. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.7031.

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7031 Background: There are a limited number of studies that have evaluated the association between National Comprehensive Cancer Network (NCCN) guideline adherence and survival across different cancers. We aim to assess the relationship between race/ethnicity, socioeconomic status (SES), insurance type and the receipt of NCCN guideline concordant cancer care and survival. Methods: This is a retrospective population-based cohort study of patients with 7 types of invasive cancer using the California Cancer Registry. Adherence with NCCN guidelines was defined by appropriate surgical, radiation, and chemo- or hormonal therapies. Multivariate logistic regression was used to evaluate the relationship between the patient, insurance type, tumor, and guideline adherence. Disease-specific survival analysis was performed using multivariate proportional hazards model. Results: A total of 543,198 patients were identified with invasive cancer between 2004-2017 (cases by disease type: breast 189,311, prostate 156,502, colon 80,102, liver 25,857, gastric 22,066, ovary 22,551, and cervix 16,691). The proportion of patients receiving NCCN guideline-concordant care varied by disease type. Non-concordant guideline treatment was associated with increased disease-specific mortality across all cancer types: breast (HR 1.28, 95%CI 1.23-1.33), prostate (HR 1.31, 95%CI 1.22-1.41), colon (HR 1.73, 95%CI 1.67-1.78), liver (HR 2.52, 95%CI 2.42-2.63), gastric (HR 2.38, 2.28-2.49), ovary (HR 1.32, 95%CI 1.26-1.38), and cervical cancer (HR 1.17, 95%CI 1.08-1.26). In multivariate models, compared to White, black patients were less likely to receive guideline concordant care for breast (OR 0.88, 95%CI 0.84-0.92), prostate (OR 0.90, 95%CI 0.86-0.93), colon (OR 0.85, 95%CI 0.79-0.92), and ovarian cancer (OR 0.71, 95%CI 0.62-0.82). Compared to Managed care insurance patients, Medicaid payer status was also associated with lower guideline concordant care for breast (OR 0.81, 95%CI 0.78-0.84), prostate (OR 0.91, 95%CI 0.86-0.97), colon (OR 0.70, 95%CI 0.65-0.75), gastric (OR 0.69, 95%CI 0.63-0.75), and liver cancer (OR 0.66, 95%CI 0.61-0.72). Conclusions: Less than half of cancer patients received NCCN guideline concordant care. There was an incremental relationship observed between SES and the likelihood of receiving guideline concordant care. Patients receiving non-guideline concordant care had worse disease-specific survival.
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Knežević, Božidarka, Ljilja Musić, Goran Batrićević, Aneta Bošković, Nebojša Bulatović, Ana Nenezić, Jelena Vujović e Milovan Kalezić. "Optimizing prevention and guideline-concordant care in Montenegro". International Journal of Cardiology 217 (agosto de 2016): S32—S36. http://dx.doi.org/10.1016/j.ijcard.2016.06.218.

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Cohen-Stavi, Chandra J., Calanit Key, Shmuel Giveon, Tchiya Molcho, Ran D. Balicer e Efrat Shadmi. "Assessing guideline-concordant care for patients with multimorbidity treated in a care management setting". Family Practice 37, n.º 4 (27 de março de 2020): 479–85. http://dx.doi.org/10.1093/fampra/cmaa024.

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Abstract Background Disease-specific guidelines are not aligned with multimorbidity care complexity. Meeting all guideline-recommended care for multimorbid patients has been estimated but not demonstrated across multiple guidelines. Objective Measure guideline-concordant care for patients with multimorbidity; assess in what types of care and by whom (clinician or patient) deviation from guidelines occurs and evaluate whether patient characteristics are associated with concordance. Methods A retrospective cohort study of care received over 1 year, conducted across 11 primary care clinics within the context of multimorbidity-focused care management program. Patients were aged 45+ years with more than two common chronic conditions and were sampled based on either being new (≤6 months) or veteran to the program (≥1 year). Measures Three guideline concordance measures were calculated for each patient out of 44 potential guideline-recommended care processes for nine chronic conditions: overall score; referral score (proportion of guideline-recommended care referred) and patient-only score (proportion of referred care completed by patients). Guideline concordance was stratified by care type. Results 4386 care processes evaluated among 204 patients, mean age = 72.3 years (standard deviation = 9.7). Overall, 79.2% of care was guideline concordant, 87.6% was referred according to guidelines and patients followed 91.4% of referred care. Guideline-concordant care varied across care types. Age, morbidity burden and whether patients were new or veteran to the program were associated with guideline concordance. Conclusions Patients with multimorbidity do not receive ~20% of guideline recommendations, mostly due to clinicians not referring care. Determining the types of care for which the greatest deviation from guidelines exists can inform the tailoring of care for multimorbidity patients.
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Kimmick, Gretchen, Steven T. Fleming, Susan A. Sabatino, Xiao-Cheng Wu, Wenke Hwang, J. Frank Wilson, Mary Jo Lund, Rosemary Cress e Roger T. Anderson. "Comorbidity Burden and Guideline-Concordant Care for Breast Cancer". Journal of the American Geriatrics Society 62, n.º 3 (10 de fevereiro de 2014): 482–88. http://dx.doi.org/10.1111/jgs.12687.

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McBride, Cameron L., Julia M. Akeroyd, David J. Ramsey, Vijay Nambi, Khurram Nasir, Erin D. Michos, Ruth L. Bush et al. "Statin prescription rates and their facility-level variation in patients with peripheral artery disease and ischemic cerebrovascular disease: Insights from the Department of Veterans Affairs". Vascular Medicine 23, n.º 3 (30 de março de 2018): 232–40. http://dx.doi.org/10.1177/1358863x18758914.

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The 2013 American College of Cardiology/American Heart Association cholesterol guideline recommends moderate to high-intensity statin therapy in patients with peripheral artery disease (PAD) and ischemic cerebrovascular disease (ICVD). We examined frequency and facility-level variation in any statin prescription and in guideline-concordant statin prescriptions in patients with PAD and ICVD receiving primary care in 130 facilities across the Veterans Affairs (VA) health care system between October 2013 and September 2014. Guideline-concordant statin intensity was defined as the prescription of high-intensity statins in patients with PAD or ICVD ≤75 years and at least moderate-intensity statins in those >75 years. We calculated median rate ratios (MRR) after adjusting for patient demographic factors to assess the magnitude of facility-level variation in statin prescribing patterns independent of patient characteristics. Among 194,151 PAD patients, 153,438 patients (79.0%) were prescribed any statin and 79,435 (40.9%) were prescribed a guideline-concordant intensity of statin. PAD patients without ischemic heart disease were prescribed any statin and a guideline-concordant intensity of statin therapy less frequently (69.1% and 28.9%, respectively). Among 339,771 ICVD patients, 265,491 (78.1%) were prescribed any statin and 136,430 (40.2%) were prescribed a guideline-concordant intensity of statin. ICVD patients without ischemic heart disease were prescribed any statin and a guideline-concordant intensity of statin less frequently (70.9% and 30.5%, respectively). MRRs for both PAD and ICVD patients demonstrated a 20% and 28% variation among two facilities in treating two identical patients with statin therapy and guideline-concordant intensity of statin therapy, respectively. The prescription of statins, especially guideline-recommended intensity of statin therapy, is suboptimal in PAD and ICVD patients, with significant facility-level variation not explained by patient-level factors.
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Teses / dissertações sobre o assunto "Guideline-concordant care"

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Jones, Laura Elizabeth. "Quality of guideline-concordant care and treatment for depression in the Veterans Health Administration and its impact on glycemic control". Diss., University of Iowa, 2006. http://ir.uiowa.edu/etd/67.

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Uematsu, Hironori. "Impact of weekend admission on in-hospital mortality in severe community-acquired pneumonia patients in Japan". 京都大学 (Kyoto University), 2017. http://hdl.handle.net/2433/225513.

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Livros sobre o assunto "Guideline-concordant care"

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Robbins, Michael, Terri Tanielian, Harold Alan Pincus, Kimberly A. Hepner, Coreen Farris, Carrie M. Farmer, Susan M. Paddock, Praise O. Iyiewuare e Asa Wilks. Delivering Clinical Practice Guideline–Concordant Care for PTSD and Major Depression in Military Treatment Facilities. RAND Corporation, 2017.

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Hepner, Kimberly, Coreen Farris, Carrie Farmer, Praise Iyiewuare, Terri Tanielian, Asa Wilks, Michael Robbins, Susan Paddock e Harold Pincus. Delivering Clinical Practice Guideline–Concordant Care for PTSD and Major Depression in Military Treatment Facilities. RAND Corporation, 2017. http://dx.doi.org/10.7249/rr1692.

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Trabalhos de conferências sobre o assunto "Guideline-concordant care"

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Atkins, G., e R. M. Klein. "Preemptive, Patient-Specific, Electronic Messaging from a Pulmonologist to Primary Care Practitioners Improves Guideline Concordant Chronic Obstructive Pulmonary Disease Care". In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a2749.

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Vyas, Ami M., Tyler Mantaian e Stephen J. Kogut. "Abstract 1566: Guideline-concordant care among women with HER2 negative metastatic breast cancer: A SEER-Medicare analysis". In Proceedings: AACR Annual Meeting 2019; March 29-April 3, 2019; Atlanta, GA. American Association for Cancer Research, 2019. http://dx.doi.org/10.1158/1538-7445.am2019-1566.

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Vyas, Ami M., Tyler Mantaian e Stephen J. Kogut. "Abstract 1566: Guideline-concordant care among women with HER2 negative metastatic breast cancer: A SEER-Medicare analysis". In Proceedings: AACR Annual Meeting 2019; March 29-April 3, 2019; Atlanta, GA. American Association for Cancer Research, 2019. http://dx.doi.org/10.1158/1538-7445.sabcs18-1566.

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Ehteshami-Afshar, S., C. Brandt e K. M. Akgun. "Sex Differences in Guideline Concordant Chronic Obstructive Pulmonary Disease Diagnosis and Management in a Primary Care Setting". In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a7158.

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Denu, Ryan A., John M. Hampton, Adam Currey, Roger T. Anderson, Rosemary D. Cress, Steven T. Fleming, Joseph Lipscomb et al. "Abstract 3727: Influence of patient, physician, and hospital characteristics on the receipt of guideline-concordant care for inflammatory breast cancer". In Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1538-7445.am2015-3727.

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Williams, CP, A. Azuero, M. Pisu, KI Halilova, S. Adewakun, SK Yagnik, H.-P. Goertz e GB Rocque. "Abstract PD7-01: Impact of guideline concordant treatment on cost and health care utilization in early stage breast cancer patients". In Abstracts: 2017 San Antonio Breast Cancer Symposium; December 5-9, 2017; San Antonio, Texas. American Association for Cancer Research, 2018. http://dx.doi.org/10.1158/1538-7445.sabcs17-pd7-01.

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Ursem, C., ST Fleming, S. Sabatino, X.-C. Wu, JF Wilson, J. Lipscomb, R. Cress, R. Anderson e G. Kimmick. "Abstract P1-09-05: Does socioeconomic status (SES) influence receipt of guideline concordant care in older women with breast cancer: Findings from a Centers for Disease Control and Prevention national program of cancer registries (NPCR) patterns of care study". In Abstracts: Thirty-Sixth Annual CTRC-AACR San Antonio Breast Cancer Symposium - Dec 10-14, 2013; San Antonio, TX. American Association for Cancer Research, 2013. http://dx.doi.org/10.1158/0008-5472.sabcs13-p1-09-05.

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Rosenberg, Shoshana M., Laura H. Hendrix, Kristin L. Schreiber, Alastair M. Thompson, Isabelle Bedrosian, Kevin S. Hughes, Thomas Lynch et al. "Abstract P1-21-07: The Patient-reported Outcomes after Routine Treatment of Atypical Lesions (PORTAL) study: Pain, psychosocial wellbeing, and quality of life among women undergoing guideline concordant care for DCIS vs. active surveillance for in situ and atypical lesions". In Abstracts: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, Texas. American Association for Cancer Research, 2020. http://dx.doi.org/10.1158/1538-7445.sabcs19-p1-21-07.

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