Peri-Operative Chemotherapy for Bladder Cancer: A Survey of Providers to Determine Barriers and Enablers
| Autor: | Deb Feldman-Stewart, Simon D. French, R. Christopher Doiron, William J. Mackillop, Christopher M. Booth, Kelly Brennan, Melanie Walker, D. Robert Siemens |
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| Rok vydání: | 2018 |
| Předmět: |
Research Report
knowledge translation medicine.medical_specialty Referral Urology medicine.medical_treatment Psychological intervention chemotherapy Logistic regression surgery 03 medical and health sciences 0302 clinical medicine quality of care Knowledge translation medicine 030212 general & internal medicine Chemotherapy Quantitative survey Bladder cancer business.industry Perioperative medicine.disease Oncology 030220 oncology & carcinogenesis Family medicine business |
| Zdroj: | Bladder Cancer (Amsterdam, Netherlands) |
| ISSN: | 2352-3735 2352-3727 |
| DOI: | 10.3233/blc-170148 |
| Popis: | Background: Utilization of chemotherapy for patients with muscle-invasive bladder cancer (MIBC) is low. In earlier qualitative work we used the Theoretical Domains Framework (TDF) to determine barriers and enablers of chemotherapy use. In this project we aimed to determine the prevalence of these barriers and enablers in Canadian physicians. Methods: Practicing Canadian urologists, medical oncologists (MOs) and radiation oncologists (ROs) participated in a specialty-specific web-based quantitative survey to assess potential barriers and enablers to chemotherapy use. Survey questions were developed that were thematically mapped to TDF domains. Logistic regression was used to identify TDF domains associated with high referral/use of chemotherapy. Results: 110 urologists, 47 MOs and 43 ROs completed the survey; response rates were 20%, 35% and 31% respectively. The mean reported survival gain associated with neoadjuvant chemotherapy (NACT) was 9%, 8%, and 7% for urologists, MOs, and ROs respectively. Among participating urologists, the TDF domains ‘social and professional role’ (OR = 16.5, 95% CI 4.6–59.2), ‘social influences’ (OR = 5.7, 95% CI 2.4–13.4) ‘beliefs about consequences’ (OR = 4.9, 95% CI 1.8–13.3) and ‘memory, attention and decision-making’ (OR = 0.50, 95% CI 0.27–0.91) were associated with MO referral rates. Among MOs, the TDF domains ‘behavioural regulation’, ‘social influences’, and ‘social and professional role’ were associated with greater use of chemotherapy (p |
| Databáze: | OpenAIRE |
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