Nationwide compliance with a multidisciplinary guideline on pancreatic cancer during 6-year follow-up
Publication year
2020Author(s)
Source
Pancreatology, 20, 8, (2020), pp. 1723-1731ISSN
Publication type
Article / Letter to editor
Display more detailsDisplay less details
Organization
Surgery
Radboudumc Extern
Journal title
Pancreatology
Volume
vol. 20
Issue
iss. 8
Page start
p. 1723
Page end
p. 1731
Subject
Radboudumc 14: Tumours of the digestive tract RIHS: Radboud Institute for Health Sciences; Surgery - Radboud University Medical CenterAbstract
BACKGROUND: Compliance with national guidelines on pancreatic cancer management could improve patient outcomes. Early compliance with the Dutch guideline was poor. The aim was to assess compliance with this guideline during six years after publication. MATERIALS AND METHODS: Nationwide guideline compliance was investigated for three subsequent time periods (2012-2013 vs. 2014-2015 vs. 2016-2017) in patients with pancreatic cancer using five quality indicators in the Netherlands Cancer Registry: 1) discussion in multidisciplinary team meeting (MDT), 2) maximum 3-week interval from final MDT to start of treatment, 3) preoperative biliary drainage when bilirubin >250 μmol/L, 4) use of adjuvant chemotherapy, and 5) chemotherapy for inoperable disease (non-metastatic and metastatic). RESULTS: In total, 14 491 patients were included of whom 2290 (15.8%) underwent resection and 4561 (31.5%) received chemotherapy. Most quality indicators did not change over time: overall, 88.8% of patients treated with curative intent were discussed in a MDT, 42.7% were treated with curative intent within the 3-week interval, 62.7% with a resectable head tumor and bilirubin >250 μmol/L underwent preoperative biliary drainage, 57.2% received chemotherapy after resection, and 36.6% with metastatic disease received chemotherapy. Only use of chemotherapy for non-metastatic, non-resected disease improved over time (23.4% vs. 25.6% vs. 29.7%). CONCLUSION: Nationwide compliance to five quality indicators for the guideline on pancreatic cancer management showed little to no improvement during six years after publication. Besides critical review of the current quality indicators, these outcomes may suggest that a nationwide implementation program is required to increase compliance to guideline recommendations.
This item appears in the following Collection(s)
- Academic publications [244084]
- Faculty of Medical Sciences [92872]
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