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Low Adherence Rates for Prostate Cancer Quality of Care Measures

Posted on Mon, May 05, 2014
Low Adherence Rates for Prostate Cancer Quality of Care Measures

Regional variation seen in pretreatment counseling, overuse of bone scans, oncologist follow-up

MONDAY, April 21, 2014 (HealthDay News) -- Adherence to established prostate cancer quality of care measures is frequently low, with considerable regional variation, according to a study published in the April issue of The Journal of Urology.

Florian R. Schroeck, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted a retrospective study to examine regional variation in adherence to quality measures for 53,614 patients with newly diagnosed prostate cancer. Patients were identified from Surveillance, Epidemiology, and End Results-Medicare data for 2001 to 2007, and were assigned to 661 regions.

The researchers observed extensive patient-level variation in adherence, varying from 33 percent for treatment by a high-volume provider to 76 percent for adjuvant androgen deprivation therapy receipt while undergoing radiation for high-risk cancer. Considerable regional variation was observed in adherence to several measures, including pretherapy counseling by a urologist and radiation oncologist, which ranged from 9 to 89 percent; avoiding bone scan overuse in low-risk cancer, which ranged from 16 to 96 percent; treatment by a high-volume provider, which ranged from 1 to 90 percent; and follow-up with a radiation oncologist, which varied from 14 to 86 percent (all P < 0.001).

"We found low adherence rates for most established prostate cancer quality of care measures. Within most measures regional variation in adherence was pronounced," the authors write. "Measures with low adherence and a large amount of regional variation may be important low hanging targets for quality improvement."

One author disclosed financial ties to Amgen; one author disclosed financial ties to Elsevier.

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