Literature DB >> 32905177

Does dissemination of guidelines alone increase the use of palliative single-fraction radiotherapy? Initial report of a longitudinal change management campaign at a provincial cancer program.

J O Kim1, N Hanumanthappa1, Y T Chung2, J Beck3, R Koul1, B Bashir1, A Cooke1, A Dubey1, J Butler1, M Nashed1, W Hunter4, A Ong1.   

Abstract

Background: Despite level 1 evidence demonstrating the equivalence of single-fraction radiotherapy (sfrt) and multiple-fraction radiotherapy (mfrt) for the palliation of painful bone metastases, sfrt remains underused. In 2015, to encourage the sustainable use of palliative radiation oncology resources, CancerCare Manitoba disseminated, to each radiation oncologist in Manitoba, guidelines from Choosing Wisely Canada (cwc) that recommend sfrt. We assessed whether dissemination of the guidelines influenced sfrt use in Manitoba in 2016, and we identified factors associated with mfrt.
Methods: All patients treated with palliative radiotherapy for bone metastasis in Manitoba from 1 January 2016 to 31 December 2016 were identified from the provincial radiotherapy database. Patient, treatment, and disease characteristics were extracted from the electronic medical record and tabulated by fractionation schedule. Univariable and multivariable logistic regression analyses were performed to identify risk factors associated with mfrt.
Results: In 2016, 807 patients (mean age: 70 years; range: 35-96 years) received palliative radiotherapy for bone metastasis, with 69% of the patients having uncomplicated bone metastasis. The most common primary malignancies were prostate (27.1%), lung (20.6%), and breast cancer (15.9%). In 62% of cases, mfrt was used-a proportion that was unchanged from 2015. On multivariable analysis, a gastrointestinal [odds ratio (or): 5.3] or lung primary (or: 3.3), complicated bone metastasis (or: 4.3), and treatment at a subsidiary site (or: 4.4) increased the odds of mfrt use. Conclusions: Dissemination of cwc recommendations alone did not increase sfrt use by radiation oncologists in 2016. A more comprehensive knowledge translation effort is therefore warranted and is now underway to encourage increased uptake of sfrt in Manitoba. 2020 Multimed Inc.

Entities:  

Keywords:  Single-fraction radiotherapy; behaviour change; bone metastasis; guideline adherence; knowledge translation; palliation; quality improvement

Mesh:

Year:  2020        PMID: 32905177      PMCID: PMC7467795          DOI: 10.3747/co.27.6193

Source DB:  PubMed          Journal:  Curr Oncol        ISSN: 1198-0052            Impact factor:   3.677


  41 in total

1.  Cost-utility analysis of short- versus long-course palliative radiotherapy in patients with non-small-cell lung cancer.

Authors:  Wilbert B van den Hout; Gijsbert W P M Kramer; Ed M Noordijk; Jan-Willem H Leer
Journal:  J Natl Cancer Inst       Date:  2006-12-20       Impact factor: 13.506

Review 2.  A phase III international randomised trial comparing single with multiple fractions for re-irradiation of painful bone metastases: National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) SC 20.

Authors:  E Chow; P J Hoskin; J Wu; D Roos; Y van der Linden; W Hartsell; R Vieth; C Wilson; J Pater
Journal:  Clin Oncol (R Coll Radiol)       Date:  2006-03       Impact factor: 4.126

3.  Impact of the Canadian Diabetes Association guideline dissemination strategy on clinician knowledge and behaviour change outcomes.

Authors:  Catherine H Yu; Erin Lillie; Alekhya Mascarenhas-Johnson; Carolyn Gall Casey; Sharon E Straus
Journal:  Diabetes Res Clin Pract       Date:  2018-04-04       Impact factor: 5.602

4.  The practice guidelines development cycle: a conceptual tool for practice guidelines development and implementation.

Authors:  G P Browman; M N Levine; E A Mohide; R S Hayward; K I Pritchard; A Gafni; A Laupacis
Journal:  J Clin Oncol       Date:  1995-02       Impact factor: 44.544

5.  Physician adherence to U.S. Preventive Services Task Force mammography guidelines.

Authors:  Jennifer Corbelli; Sonya Borrero; Rachel Bonnema; Megan McNamara; Kevin Kraemer; Doris Rubio; Irina Karpov; Melissa McNeil
Journal:  Womens Health Issues       Date:  2014 May-Jun

6.  Impact of Using Audit Data to Improve the Evidence-Based Use of Single-Fraction Radiation Therapy for Bone Metastases in British Columbia.

Authors:  Robert A Olson; Manpreet Tiwana; Mark Barnes; Eric Cai; Colleen McGahan; Kelsey Roden; Emily Yurkowski; Quinn Gentles; John French; Ross Halperin; Ivo A Olivotto
Journal:  Int J Radiat Oncol Biol Phys       Date:  2015-07-08       Impact factor: 7.038

7.  International patterns of practice in palliative radiotherapy for painful bone metastases: evidence-based practice?

Authors:  Alysa Fairchild; Elizabeth Barnes; Sunita Ghosh; Edgar Ben-Josef; Daniel Roos; William Hartsell; Tanya Holt; Jackson Wu; Nora Janjan; Edward Chow
Journal:  Int J Radiat Oncol Biol Phys       Date:  2009-05-21       Impact factor: 7.038

Review 8.  Palliation of metastatic bone pain: single fraction versus multifraction radiotherapy--a systematic review of randomised trials.

Authors:  W M Sze; M D Shelley; I Held; T J Wilt; M D Mason
Journal:  Clin Oncol (R Coll Radiol)       Date:  2003-09       Impact factor: 4.126

9.  Email as an Encumbrance to Physician-patient Communication.

Authors:  William C Welch; Melissa S Mathew; Rachel L Welch; Brendan J McShane
Journal:  Cureus       Date:  2019-01-03

10.  Radiotherapy fractionation for the palliation of uncomplicated painful bone metastases - an evidence-based practice guideline.

Authors:  Jackson Sai-Yiu Wu; Rebecca K S Wong; Nancy S Lloyd; Mary Johnston; Andrea Bezjak; Timothy Whelan
Journal:  BMC Cancer       Date:  2004-10-04       Impact factor: 4.430

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  2 in total

Review 1.  Creation of clinical algorithms for decision-making in oncology: an example with dose prescription in radiation oncology.

Authors:  Fabio Dennstädt; Theresa Treffers; Thomas Iseli; Cédric Panje; Paul Martin Putora
Journal:  BMC Med Inform Decis Mak       Date:  2021-07-12       Impact factor: 2.796

2.  An Intensive Educational Intervention Significantly Improves the Adoption of Single Fractionation Radiotherapy in Uncomplicated Bone Metastases.

Authors:  Costanza M Donati; Elena Nardi; Erika Galietta; Maria L Alfieri; Giambattista Siepe; Alice Zamagni; Milly Buwenge; Gabriella Macchia; Francesco Deodato; Savino Cilla; Lidia Strigari; Silvia Cammelli; Francesco Cellini; Alessio G Morganti
Journal:  Clin Med Insights Oncol       Date:  2021-07-22
  2 in total

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