Impact of Guideline-Discordant Treatment on Cost and Health Care Utilization in Older Adults with Early-Stage Breast Cancer.
Courtney P WilliamsKelly M KenzikAndres AzueroGrant R WilliamsMaria PisuKarina I HalilovaStacey A IngramSupriya K YagnikAndres ForeroSmita BhatiaGabrielle B RocquePublished in: The oncologist (2018)
Previous studies lack details about types of deviations from chemotherapy guidelines that occur in older early-stage breast cancer patients. Understanding the patterns of guideline discordance and its impact on patient outcomes will be particularly important for these patients. This study found 16% received guideline-discordant care, predominantly related to reduced intensity treatment and associated with higher costs and rates of health care utilization. Increasing older adult participation in clinical trials should be a priority in order to fill the knowledge gap about how to treat older, less fit patients with breast cancer.
Keyphrases
- healthcare
- early stage
- physical activity
- community dwelling
- middle aged
- clinical trial
- end stage renal disease
- ejection fraction
- chronic kidney disease
- palliative care
- randomized controlled trial
- prognostic factors
- squamous cell carcinoma
- peritoneal dialysis
- quality improvement
- lymph node
- high intensity
- african american
- young adults
- neoadjuvant chemotherapy
- study protocol
- combination therapy
- patient reported
- patient reported outcomes