An analysis of self-reported data from outpatient oncology practices participating in the American Society of Clinical Oncology?s (ASCO)Quality Oncology Practice Initiative (QOPI?) showed marked improvements in overall quality of care delivered over a four-year period.The QOPI tool, created by ASCO, is a method for measurement of process based practice quality and is available since 2006. Thisanalysis shows that thegreatest improvement was seen in measures assessing the adoption of new clinical practices. The studies wasreleased in a presscast today in advance of ASCO?s inaugural 2012 Quality Care Symposium. The Symposium will take place November 30 ? December 1, 2012, at the Manchester Grand Hyatt in San Diego, CA.

These findings indicate that the oncology practices which participate in the QOPI, an oncologist-led qualitymeasurement program, are able to document significant and rapid improvement in their overall performance resulting from progress in many but not all measures of care. ?This is reassuring evidence that the level of care received in oncology practices that participate in QOPI is very high and that new treatments are rapidly incorporated into practice,? said lead author Michael N. Neuss, MD, chief medical officer at the Vanderbilt-Ingram Cancer Center.

Improving Quality Adherence

Across the 156 oncology practices included in this analysis, researchers observed that the mean quality adherence scores improved from 71 to 85% between 2006 and 2010. Mean scores assessing implementation of new clinical practices based on new guidelines or clinical evidence improved from 5 to 69% overall. These new clinical practices include obtaining genetic testing to predict response to treatment in patients with metastatic colorectal cancer, adequate lymph node examination after surgery in colorectal cancer, testing for KRAS gene alterations when administering anti-EGFR therapy, and use of the anti-nausea drug aprepitant.

However, a number of measures, including those related to smoking cessation and fertility preservation counseling (for patients undergoing treatment that could render them infertile) did not improve over time, reflecting that there is a need for attention in some areas.

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The analysis included 156 practices that completed at least two rounds of QOPI data collection and reported on 30 or more patients per round. Quality scores (rates of adherence to quality measures) were calculated for all seven QOPI modules (core, symptom management, end of life, non-Hodgkin?s lymphoma, breast cancer, colorectal cancer, and non-small cell lung cancer).

National Quality Assessement

QOPI is a national quality assessment and improvement program involving more than 800 registered oncology practices across the country that is designed to measure care provided in outpatient oncology practices against evidence-based and expert consensus care recommendations, and therefore inform quality improvement activities. Participation in QOPI is voluntary, and has been growing steadily since its inception in 2006.

New strategies

?Ensuring that our patients receive the highest quality care possible is a core responsibility of oncology. This and other studiespresentedat ASCO?s inaugural 2012 Quality Care Symposium show us new strategies for measuring and improving our adherence to quality standards,? notedJyoti Patel, MD, ASCO Committee member. ?The findings also provide insight on discussing treatment options for patients with both early-stage and advanced cancers.?

General Session: III/IT Interventions to Improve Cancer Care Quality
Date: Saturday, December 1, 2012, 8:00 – 8:10 PM PST
Authors: Neuss MN, Malin J, Chan S, Kadlubek P, Adams JL, Joseph J, Blayney D, Simone JV, Vanderbilt-Ingram Cancer Center, Nashville, Tenn.
Abstract: #66
Title: Measuring the improving quality of outpatientcare in medical oncology practices in the United States
Location: Douglas Pavilion B

For more information:

– Clinical Oncology?s Quality Oncology Practice Initiative (QOPI?)

Reference:

Neuss MN, Malin J, Chan S, Kadlubek P, Adams JL, Joseph J, Blayney D, Simone JV. Measuring the improving quality of outpatient care in medical oncology practices in the United States. J Clin Oncol 30, 2012 (suppl 34; abstr 66)

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