BACKGROUND: Treatment uptake and elapsed times along the care path have emerged as potential quality indicators for cancer care delivery. This retrospective study examined changes in adjuvant chemotherapy uptake and elapsed times along the care path for patients in 2005 and in 2007 who had early-stage non-small-cell lung cancer (nsclc) and who underwent curative-intent surgery in Nova Scotia, Canada. METHODS: All patients who underwent curative-intent surgery for stages i-iii nsclc in the two years of interest were included. Logistic regression and general linear models were used to examine factors associated with chemotherapy uptake patterns and, at various resolutions (low, intermediate, high), elapsed times between all care events in the care path. RESULTS: In the 223 patients who underwent curative-intent surgery (108 in 2005, 115 in 2007), several factors were associated with uptake patterns and elapsed times. Cohort year (2007 vs. 2005) was not associated with referral to medical oncology [odds ratio (or): 1.05; 95% confidence interval (ci): 0.51 to 2.15; p = 0.905], but it was associated with less treatment after referral (or: 0.34; 95% ci: 0.11 to 1.00; p = 0.057) and less overall uptake (or: 0.35; 95% ci: 0.13 to 0.95; p = 0.040). Patients were referred sooner to medical oncology in 2007 than in 2005 (21 days vs. 35 days, p = 0.008), but experienced longer waits between consultation and chemotherapy delivery (18 days vs. 7 days, p = 0.001). CONCLUSIONS: Significant differences were observed in care patterns over time. Frequent monitoring of care patterns at high resolution may optimize insights into emerging trends within cancer care systems.
BACKGROUND: Treatment uptake and elapsed times along the care path have emerged as potential quality indicators for cancer care delivery. This retrospective study examined changes in adjuvant chemotherapy uptake and elapsed times along the care path for patients in 2005 and in 2007 who had early-stage non-small-cell lung cancer (nsclc) and who underwent curative-intent surgery in Nova Scotia, Canada. METHODS: All patients who underwent curative-intent surgery for stages i-iii nsclc in the two years of interest were included. Logistic regression and general linear models were used to examine factors associated with chemotherapy uptake patterns and, at various resolutions (low, intermediate, high), elapsed times between all care events in the care path. RESULTS: In the 223 patients who underwent curative-intent surgery (108 in 2005, 115 in 2007), several factors were associated with uptake patterns and elapsed times. Cohort year (2007 vs. 2005) was not associated with referral to medical oncology [odds ratio (or): 1.05; 95% confidence interval (ci): 0.51 to 2.15; p = 0.905], but it was associated with less treatment after referral (or: 0.34; 95% ci: 0.11 to 1.00; p = 0.057) and less overall uptake (or: 0.35; 95% ci: 0.13 to 0.95; p = 0.040). Patients were referred sooner to medical oncology in 2007 than in 2005 (21 days vs. 35 days, p = 0.008), but experienced longer waits between consultation and chemotherapy delivery (18 days vs. 7 days, p = 0.001). CONCLUSIONS: Significant differences were observed in care patterns over time. Frequent monitoring of care patterns at high resolution may optimize insights into emerging trends within cancer care systems.
Authors: Timothy Winton; Robert Livingston; David Johnson; James Rigas; Michael Johnston; Charles Butts; Yvon Cormier; Glenwood Goss; Richard Inculet; Eric Vallieres; Willard Fry; Drew Bethune; Joseph Ayoub; Keyue Ding; Lesley Seymour; Barbara Graham; Ming-Sound Tsao; David Gandara; Kenneth Kesler; Todd Demmy; Frances Shepherd Journal: N Engl J Med Date: 2005-06-23 Impact factor: 91.245
Authors: Giorgio V Scagliotti; Roldano Fossati; Valter Torri; Lucio Crinò; Giuseppe Giaccone; Giovanni Silvano; Massimo Martelli; Maurizia Clerici; Francesco Cognetti; Maurizio Tonato Journal: J Natl Cancer Inst Date: 2003-10-01 Impact factor: 13.506
Authors: Katherine M W Pisters; William K Evans; Christopher G Azzoli; Mark G Kris; Christopher A Smith; Christopher E Desch; Mark R Somerfield; Melissa C Brouwers; Gail Darling; Peter M Ellis; Laurie E Gaspar; Harvey I Pass; David R Spigel; John R Strawn; Yee C Ung; Frances A Shepherd Journal: J Clin Oncol Date: 2007-10-22 Impact factor: 44.544
Authors: Jean-Pierre Pignon; Hélène Tribodet; Giorgio V Scagliotti; Jean-Yves Douillard; Frances A Shepherd; Richard J Stephens; Ariane Dunant; Valter Torri; Rafael Rosell; Lesley Seymour; Stephen G Spiro; Estelle Rolland; Roldano Fossati; Delphine Aubert; Keyue Ding; David Waller; Thierry Le Chevalier Journal: J Clin Oncol Date: 2008-05-27 Impact factor: 44.544