2026-07-16T12:36:04Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/230372024-11-29T02:27:32Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967col_20.500.12105_16972
Repisalud
author
Niño de Guzman, Ena
author
Song, Yang
author
Alonso-Coello, Pablo
author
Canelo-Aybar, Carlos
author
Neamtiu, Luciana
author
Parmelli, Elena
author
Perez-Bracchiglione, Javier
author
Rabassa, Montserrat
author
Rigau, David
author
Parkinson, Zuleika Saz
author
Sola, Ivan
author
Vasquez-Mejia, Adrian
author
Ricci-Cabello, Ignacio
2024-09-13T09:15:58Z
2024-09-13T09:15:58Z
2020-06
Niño de Guzman E, Song Y, Alonso-Coello P, Canelo-Aybar C, Neamtiu L, Parmelli E, et al. Healthcare providers' adherence to breast cancer guidelines in Europe: a systematic literature review. Breast Cancer Res Treat. 2020 Jun;181(3):499-518. Epub 2020 May 6.
10.1007/s10549-020-05657-8
1573-7217
0167-6806
Breast Cancer Research and Treatment
http://hdl.handle.net/20.500.13003/10698
32378052
L2004857375
2-s2.0-85084677143
https://hdl.handle.net/20.500.12105/23037
531334100002
Purpose: Clinical guidelines' (CGs) adherence supports high-quality care. However, healthcare providers do not always comply with CGs recommendations. This systematic literature review aims to assess the extent of healthcare providers' adherence to breast cancer CGs in Europe and to identify the factors that impact on healthcare providers' adherence. Methods: We searched for systematic reviews and quantitative or qualitative primary studies in MEDLINE and Embase up to May 2019. The eligibility assessment, data extraction, and risk of bias assessment were conducted by one author and cross-checked by a second author. We conducted a narrative synthesis attending to the modality of the healthcare process, methods to measure adherence, the scope of the CGs, and population characteristics. Results: Out of 8137 references, we included 41 primary studies conducted in eight European countries. Most followed a retrospective cohort design (19/41; 46%) and were at low or moderate risk of bias. Adherence for overall breast cancer care process (from diagnosis to follow-up) ranged from 54 to 69%; for overall treatment process [including surgery, chemotherapy (CT), endocrine therapy (ET), and radiotherapy (RT)] the median adherence was 57.5% (interquartile range (IQR) 38.8-67.3%), while for systemic therapy (CT and ET) it was 76% (IQR 68-77%). The median adherence for the processes assessed individually was higher, ranging from 74% (IQR 10-80%), for the follow-up, to 90% (IQR 87-92.5%) for ET. Internal factors that potentially impact on healthcare providers' adherence were their perceptions, preferences, lack of knowledge, or intentional decisions. Conclusions: A substantial proportion of breast cancer patients are not receiving CGs-recommended care. Healthcare providers' adherence to breast cancer CGs in Europe has room for improvement in almost all care processes. CGs development and implementation processes should address the main factors that influence healthcare providers' adherence, especially patient-related ones. Registration: PROSPERO (CRD42018092884).
eng
Breast neoplasms
Guidelines as topic
Evidence-based medicine
Guideline adherence
Systematic review
Healthcare providers' adherence to breast cancer guidelines in Europe: a systematic literature review
review article