To evaluate adherence to treatment guideline recommendations across the continuum of prostate cancer care by US community urologists using several prostate cancer (PCa) specific performance indicators (PIs). Additionally, to determine which practice-related factors, such as having a designated PCa patient champion, active patient management in a patient portal, and in-office dispensing of medications, were associated with improved PI performance.
Electronic medical record data was collected retrospectively from the PPS Analytics Patient Population Health Management Platform. The cohort consisted of adult patients with a PCa-related service visit during the period 7/1/2019 to 6/30/2022. Five PIs were reviewed: dual-energy x-ray absorptiometry (DEXA) scanning with androgen deprivation therapy (ADT), systemic therapy in metastatic PCa, external beam radiation therapy (EBRT) concurrent with ADT, image monitoring, and regular testosterone testing and monitoring.
A total of 101,186 patients were identified from 95 urology practices. PI adherence rates ranged from a low of 13.6% for a DEXA scan within 6-months of ADT initiation to a high of 72.3% for EBRT concurrent with ADT in intermediate/high risk localized PCa. The results also demonstrated that several practice-related features were associated with better PI adherence.
The findings suggest there exists a wide range in PI adherence rates for urologists in the delivery of community urology care in the Unites States compared to clinical guideline recommendations. Future research should examine the factors associated with PI nonadherence and promote implementation of interventions that enhance guideline concordant care.
Urology. 2024 Nov 01 [Epub ahead of print]
Neal Shore, Gordon Brown, Benjamin Lowentritt, Lorraine O'Donnell, Wanda Wilt, Sabree Burbage, Ibrahim Khilfeh, Franklin Gaylis
Carolina Urologic Research Center, Myrtle Beach, SC., New Jersey Urology, A Summit Health Company and Rowan University of Osteopathic Medicine, Statford, NJ., Chesapeake Urology, Towson, MD., Specialty Networks, Cleveland, OH., Janssen Scientific Affairs, LLC, a Johnson & Johnson Company, Horsham, PA., Janssen Scientific Affairs, LLC, a Johnson & Johnson Company, Horsham, PA. Electronic address: ., Genesis Healthcare Partners, San Diego, CA.