Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study
Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study
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DOI：
10.1177/00034894221098471
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发表时间：
2022-06
期刊：
影响因子：
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通讯作者：
Jordan R. Salley;A. Day;S. Balachandra;Joshua Mehr;B. Sumer;D. Sher;E. Mayfield Arnold;Esther Danphuong Ho;S. Lee;Rebecca L. Eary
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文献类型：
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作者：
Jordan R. Salley;A. Day;S. Balachandra;Joshua Mehr;B. Sumer;D. Sher;E. Mayfield Arnold;Esther Danphuong Ho;S. Lee;Rebecca L. Eary
目的：这项研究的目的是探讨美国癌症协会(ACS)头颈部癌症(HNC)生存护理指南及其概述的33项建议在治疗后头颈部癌症(HNC)幸存者中的遵守情况。方法：设计一项双机构、回顾性、嵌套式队列研究，研究对象为2018年确诊的粘膜或唾液腺HNC幸存者。在肿瘤治疗完成后0-13个月，通过回顾图表评估指南的依从性，根据4个类别：(1)问题评估，(2)问题诊断，(3)提供管理；(4)问题处理。遵守被定义为在13个月期间至少满足一次推荐子类别。结果：在随机选择的60名HNC幸存者中，在排除了不符合条件的癌症患者和在研究期间死亡或失去随访的人后，共有38人进入最终队列。大约95%的HNC幸存者接受了HNC复发评估和肺癌筛查。在符合条件的幸存者中，70%的患者对某些常见问题进行了筛查和处理，如口干、吞咽困难和甲状腺功能减退。相反，筛查其他第二原发癌和评估大多数其他身体和心理社会伤害发生在70%的幸存者身上，而在许多情况下，少数幸存者没有发生过(例如，睡眠呼吸暂停和睡眠障碍，身体和自我形象问题)。只有5%的幸存者接受了生存护理计划。结论：治疗后早期幸存者对美国癌症学会HNC生存护理指南的总体依从性并不理想。需要采取干预措施，以便更好地执行和实施这些准则建议。
Objectives: The purpose of this study was to explore adherence to the American Cancer Society (ACS) Head and Neck Cancer (HNC) Survivorship Care Guideline and their outlined 33 recommendations among posttreatment HNC survivors. Methods: A bi-institutional, retrospective, nested cohort study of mucosal or salivary gland HNC survivors diagnosed in 2018 was designed. Guideline adherence was assessed via retrospective chart review between 0 and 13 months after completion of oncologic treatment according to 4 categories: (1) problem assessed, (2) problem diagnosed, (3) management offered; (4) problem treated. Adherence was defined as meeting a recommendation subcategory at least once over the 13-month period. Results: Among 60 randomly selected HNC survivors, a total of 38 were included in the final cohort after exclusion of individuals with ineligible cancers and those who died or were lost to follow-up over the study period. Approximately 95% of HNC survivors were assessed for HNC recurrence and screened for lung cancer. Certain common problems such as xerostomia, dysphagia, and hypothyroidism were screened for and managed in ≥70% of eligible survivors. Conversely, screening for other second primary cancers and assessment of a majority of other physical and psychosocial harms occurred in <70% of survivors, and in many cases none to a slim minority of survivors (eg, sleep apnea and sleep disturbance, body and self-image concerns). Only 5% of survivors received a survivorship care plan. Conclusion: Overall adherence to the ACS HNC Survivorship Care Guideline in early posttreatment survivors was suboptimal. Interventions are needed to better implement and operationalize these guideline recommendations.