Translating Research Into Practice

The Role of Provider-based Research Networks in the Diffusion of an Evidence-based Colon Cancer Treatment Innovation

Bibliographic Data

ID9105062
AuthorsWilliam R Carpenter (Department of Health, corresponding author), Anne-Marie Meyer (University of North Carolina Health Care), Yang Wu (0000-0002-0014-603X, University of North Carolina Health Care), Bahjat Qaqish, Bahjat F Qaqish (0000-0002-5154-2059, University of North Carolina at Chapel Hill), Hanna K Sanoff (0000-0001-8679-4486, University of Virginia), Richard M Goldberg (0000-0003-0308-8223, University of North Carolina Health Care), Bryan J Weiner (0000-0002-6996-9480, University of North Carolina Health Care, corresponding author)
Year2012
Volume50
Issue8
Pages737-748
Publication date2012-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31824ebe13
PMID22437624
PMCIDPMC3389231
OpenAlexW2001728553
LanguageEN
Citations received2
References cited22

BACKGROUND: Provider-based research networks (PBRNs)--collaborative research partnerships between academic centers and community-based practitioners--are a promising model for accelerating the translation of research into practice; however, empirical evidence of accelerated translation is limited. Oxaliplatin in adjuvant combination chemotherapy is an innovation with clinical trial-proven survival benefit compared with prior therapies. The goal of this study is to examine the diffusion of oxaliplatin into community practice, and whether affiliation with the National Cancer Institute's (NCI's) Community Clinical Oncology Program (CCOP)--a nationwide cancer-focused PBRN--is associated with accelerated innovation adoption. DESIGN, SETTING, AND PARTICIPANTS: This retrospective observational study used linked Surveillance, Epidemiology, and End Results-Medicare and NCI CCOP data to examine Medicare participants with stage III colon cancer initiating treatment in 2003 through 2006, the years surrounding oxaliplatin's Food and Drug Administration approval. A fixed-effects analysis examined chemotherapy use among patients treated outside academic centers at CCOP-affiliated practices compared with non-CCOP practices. Two-group modeling controlled for multiple levels of clustering, year of chemotherapy initiation, tumor characteristics, patient age, race, comorbidity, Medicaid dual-eligibility status, and education. RESULTS: Of 4055 community patients, 35% received 5-fluoruracil, 20% received oxaliplatin, 7% received another chemotherapy, and 38% received no chemotherapy. Twenty-five percent of CCOP patients received oxaliplatin, compared with 19% of non-CCOP patients. In multivariable analysis, CCOP exposure was associated with higher odds of receiving guideline-concordant treatment in general, and oxaliplatin specifically. CONCLUSIONS: These findings contribute to a growing set of evidence linking PBRNs with a greater probability of receiving treatment innovations and high-quality cancer care, with implications for clinical and research policy

Cancer · Colorectal cancer · Community practice · Family medicine · Health services research · Logistic regression · Medicaid · Observational study · Odds · Oxaliplatin · Public health · Colorectal Cancer Treatments and Studies · Economic and Financial Impacts of Cancer · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Nursing · Oncology