The Impact of Patient Management Guidelines on the Care of Breast, Colorectal, and Ovarian Cancer Patients in Italy
Bibliographic Data
| ID | 9104247 |
|---|---|
| Authors | Roberto Grilli (0000-0001-9425-7170, corresponding author), Giovanni Apolone (0000-0001-5179-104X, Mario Negri Institute for Pharmacological Research, corresponding author), Silvia Marsoni (0000-0002-5361-7122, Candiolo Cancer Institute, corresponding author), Antonio Nicolucci (0000-0002-9600-967X, Mario Negri Sud Foundation), Paolo Zola (0000-0002-1021-4585, University of Turin), Alessandro Liberati (Mario Negri Institute for Pharmacological Research, corresponding author) |
| Year | 1991 |
| Volume | 29 |
| Issue | 1 |
| Pages | 50-63 |
| Publication date | 1991-01-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-199101000-00005 |
| PMID | 1986177 |
| OpenAlex | W2033364001 |
| Language | EN |
| Citations received | 6 |
| References cited | 3 |
The impact of a national education program based on the dissemination of written guidelines for the treatment of breast, colorectal, and ovarian cancer was investigated in Italy. Through a survey of 770 physicians exploring their knowledge and attitudes and a review of medical records of 1,483 patients assessing current clinical practice, this study examined whether 1) the guidelines reached the target population of physicians, 2) they were effective in shaping doctors' opinions, and 3) care patterns conformed with the guidelines. Overall, the net effect of the intervention appeared to be limited in terms of actual diffusion, attributable influence, and impact. As for diffusion, only 60%, 47%, and 44% of doctors were aware of breast, colorectal, and ovarian cancer guidelines, respectively. Although doctors who were aware of the guidelines had more appropriate opinions than those who were not, overall agreement with recommendations was often unsatisfactory. With reference to guidelines recommendations, quality of care was far from optimal, especially in relation to diagnosis and staging. Marked variations in compliance with recommendations emerged with values ranging from 37% to 89%, from 48% to 82%, and from 10% to 97% for breast, colorectal, and ovarian cancer, respectively, and this held true even in hospitals where the larger awareness of the guidelines might have been expected to result in better quality care. It was concluded that any thorough assessment of the impact of educational interventions should include a careful analysis of the strategy and process of dissemination. The availability of clinically relevant messages must also be realistically considered before deciding whether the "guidelines approach" is the strategy most likely to succeed
Breast cancer · Cancer · Colorectal cancer · Family medicine · Gynecology · Intervention (counseling) · MEDLINE · Population · Psychological intervention · Clinical practice guidelines implementation · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Nursing · Patient-Provider Communication in Healthcare
Evaluation of medical audit
Evaluating the Message
Why Don't Physicians Follow Clinical Practice Guidelines?
Inappropriate Halsted mastectomy and patient volume in Italian hospitals
The Awareness-to-Adherence Model of the Steps to Clinical Guideline Compliance
Physicians' view of practice guidelines. A survey of Italian physicians
| Citations per year | 0.18 |
|---|---|
| Citation span | 1993 - 1999 (7) |
| Highly cited | No |