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|Title:||Healthcare providers’ adherence to breast cancer guidelines in Europe: a systematic literature review|
|Authors:||NIÑO DE GUZMÁN QUISPE ENA PERY; SONG YANG; ALONSO-COELLO PABLO; CANELO-AYBAR CARLOS; NEAMTIU LUCIANA; PARMELLI ELENA; PÉREZ-BRACCHIGLIONE JAVIER; RABASSA MONTSERRAT; RIGAU DAVID; SAZ PARKINSON ZULEIKA ESTHER; SOLA ARNAU IVAN; VÁSQUEZ-MEJÍA ADRIÁN; RICCI-CABELLO IGNACIO|
|Citation:||BREAST CANCER RESEARCH AND TREATMENT vol. 181 p. 499-518|
|Type:||Articles in periodicals and books|
|Abstract:||Background: Clinical guidelines’ (CGs) adherence supports high quality care. However, healthcare providers do not always comply with CGs recommendations. This systematic literature review aims to assess the extent of healthcare providers’ adherence to breast cancer CGs in Europe, and to identify the factors that impact on healthcare providers’ adherence. Methods: We searched for systematic reviews, and quantitative or qualitative primary studies in MEDLINE and Embase up to May 2019. Eligibility assessment, data extraction, and risk of bias assessment were conducted by one author and crosschecked by a second author. We conducted a narrative synthesis attending to the modality of healthcare process, methods to measure adherence, scope of the CGs, and population characteristics. Results: Out of 8137 references, we included 55 primary studies conducted in eight European countries. Most followed a retrospective cohort design (31/55; 56%) and were at low or moderate risk of bias. Adherence for overall breast cancer care process (from diagnosis to follow-up) ranged from 59% to 67%, for overall treatment process (including surgery, chemotherapy (CT), endocrine therapy (ET), and radiotherapy (RT)) the median adherence was 55% (IQR 49-52%), while for systemic therapy (CT and ET) it was 68% (IQR 69-76%). The median adherence rates for individual process were higher, with a range between 74% (IQR 10-80%) for follow-up to 88% (IQR 84-92%) for RT. Internal factors that potentially impact on healthcare providers’ adherence were their perceptions, preferences, lack of knowledge, or intentional decisions. Conclusions: A substantial proportion of breast cancer patients are not receiving CGs recommended care. Healthcare providers’ adherence to breast cancer CGs in Europe has room for improvement in almost all care processes. CGs development and implementation processes should address the main factors that influence healthcare providers' adherence, especially the patient-related ones.|
|JRC Directorate:||Health, Consumers and Reference Materials|
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