Current variations in childhood cancer supportive care in the Netherlands

Erik A H Loeffen, Renée L Mulder, Marianne D van de Wetering, Anna Font-Gonzalez, Floor C H Abbink, Lynne M Ball, Jan L C M Loeffen, Erna M C Michiels, Heidi Segers, Leontien C M Kremer, Wim J E Tissing

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Current treatment strategies in pediatric oncology are intensive and lead to high survival rates but also to treatment-related complications. Therefore, supportive care plays an increasingly important role. This study was designed to evaluate variations in supportive care practice in children with cancer in the Netherlands and adherence to selected existing international guidelines through an in-depth review of local guidelines and protocols at all 6 Dutch pediatric cancer centers.

METHODS: Based on shared expert opinion, a questionnaire regarding current supportive care practice was compiled. For each center, the required information was extracted from local supportive care guidelines, and the list was sent to a pediatric oncologist of that center to verify its correspondence with local daily practice. Subsequently, it was determined whether clinical practice was concordant (same in ≥ 5 of 6 centers), partly concordant (highly overlapping in ≥ 5 of 6 centers), or discordant (same in < 5 of 6 centers). Local practices were compared with strong recommendations from high-quality, evidence-based guidelines.

RESULTS: The questionnaire comprised 67 questions regarding supportive care practice. Concordance was observed for 11 of 67 practice items (16%), partial concordance was observed for 6 of 67 practice items (9%), and discordance was observed for 50 of 67 practice items (75%). Adherence to strong recommendations of 4 high-quality, evidence-based guidelines varied but was generally low.

CONCLUSIONS: Large variations exist in pediatric oncology supportive care practice, and this could negatively influence care. Adherence to existing evidence-based guidelines and the development and implementation of new clinical practice guidelines have the potential of standardizing supportive care practice and thereby improving outcomes for children with cancer.

Original languageEnglish
Pages (from-to)642-50
Number of pages9
JournalCancer
Volume122
Issue number4
DOIs
Publication statusPublished - 15 Feb 2016

Cite this

Loeffen, E. A. H., Mulder, R. L., van de Wetering, M. D., Font-Gonzalez, A., Abbink, F. C. H., Ball, L. M., ... Tissing, W. J. E. (2016). Current variations in childhood cancer supportive care in the Netherlands. Cancer, 122(4), 642-50. https://doi.org/10.1002/cncr.29799
Loeffen, Erik A H ; Mulder, Renée L ; van de Wetering, Marianne D ; Font-Gonzalez, Anna ; Abbink, Floor C H ; Ball, Lynne M ; Loeffen, Jan L C M ; Michiels, Erna M C ; Segers, Heidi ; Kremer, Leontien C M ; Tissing, Wim J E. / Current variations in childhood cancer supportive care in the Netherlands. In: Cancer. 2016 ; Vol. 122, No. 4. pp. 642-50.
@article{8ac24673f34c4de8a8fa78aea527f19b,
title = "Current variations in childhood cancer supportive care in the Netherlands",
abstract = "BACKGROUND: Current treatment strategies in pediatric oncology are intensive and lead to high survival rates but also to treatment-related complications. Therefore, supportive care plays an increasingly important role. This study was designed to evaluate variations in supportive care practice in children with cancer in the Netherlands and adherence to selected existing international guidelines through an in-depth review of local guidelines and protocols at all 6 Dutch pediatric cancer centers.METHODS: Based on shared expert opinion, a questionnaire regarding current supportive care practice was compiled. For each center, the required information was extracted from local supportive care guidelines, and the list was sent to a pediatric oncologist of that center to verify its correspondence with local daily practice. Subsequently, it was determined whether clinical practice was concordant (same in ≥ 5 of 6 centers), partly concordant (highly overlapping in ≥ 5 of 6 centers), or discordant (same in < 5 of 6 centers). Local practices were compared with strong recommendations from high-quality, evidence-based guidelines.RESULTS: The questionnaire comprised 67 questions regarding supportive care practice. Concordance was observed for 11 of 67 practice items (16{\%}), partial concordance was observed for 6 of 67 practice items (9{\%}), and discordance was observed for 50 of 67 practice items (75{\%}). Adherence to strong recommendations of 4 high-quality, evidence-based guidelines varied but was generally low.CONCLUSIONS: Large variations exist in pediatric oncology supportive care practice, and this could negatively influence care. Adherence to existing evidence-based guidelines and the development and implementation of new clinical practice guidelines have the potential of standardizing supportive care practice and thereby improving outcomes for children with cancer.",
keywords = "Antineoplastic Agents, Child, Drug-Related Side Effects and Adverse Reactions, Evidence-Based Medicine, Humans, Medical Oncology, Neoplasms, Netherlands, Pain Management, Palliative Care, Practice Guidelines as Topic, Practice Patterns, Physicians', Radiation Injuries, Radiotherapy, Surveys and Questionnaires, Journal Article, Research Support, Non-U.S. Gov't",
author = "Loeffen, {Erik A H} and Mulder, {Ren{\'e}e L} and {van de Wetering}, {Marianne D} and Anna Font-Gonzalez and Abbink, {Floor C H} and Ball, {Lynne M} and Loeffen, {Jan L C M} and Michiels, {Erna M C} and Heidi Segers and Kremer, {Leontien C M} and Tissing, {Wim J E}",
note = "{\circledC} 2015 American Cancer Society.",
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Loeffen, EAH, Mulder, RL, van de Wetering, MD, Font-Gonzalez, A, Abbink, FCH, Ball, LM, Loeffen, JLCM, Michiels, EMC, Segers, H, Kremer, LCM & Tissing, WJE 2016, 'Current variations in childhood cancer supportive care in the Netherlands' Cancer, vol. 122, no. 4, pp. 642-50. https://doi.org/10.1002/cncr.29799

Current variations in childhood cancer supportive care in the Netherlands. / Loeffen, Erik A H; Mulder, Renée L; van de Wetering, Marianne D; Font-Gonzalez, Anna; Abbink, Floor C H; Ball, Lynne M; Loeffen, Jan L C M; Michiels, Erna M C; Segers, Heidi; Kremer, Leontien C M; Tissing, Wim J E.

In: Cancer, Vol. 122, No. 4, 15.02.2016, p. 642-50.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Current variations in childhood cancer supportive care in the Netherlands

AU - Loeffen, Erik A H

AU - Mulder, Renée L

AU - van de Wetering, Marianne D

AU - Font-Gonzalez, Anna

AU - Abbink, Floor C H

AU - Ball, Lynne M

AU - Loeffen, Jan L C M

AU - Michiels, Erna M C

AU - Segers, Heidi

AU - Kremer, Leontien C M

AU - Tissing, Wim J E

N1 - © 2015 American Cancer Society.

PY - 2016/2/15

Y1 - 2016/2/15

N2 - BACKGROUND: Current treatment strategies in pediatric oncology are intensive and lead to high survival rates but also to treatment-related complications. Therefore, supportive care plays an increasingly important role. This study was designed to evaluate variations in supportive care practice in children with cancer in the Netherlands and adherence to selected existing international guidelines through an in-depth review of local guidelines and protocols at all 6 Dutch pediatric cancer centers.METHODS: Based on shared expert opinion, a questionnaire regarding current supportive care practice was compiled. For each center, the required information was extracted from local supportive care guidelines, and the list was sent to a pediatric oncologist of that center to verify its correspondence with local daily practice. Subsequently, it was determined whether clinical practice was concordant (same in ≥ 5 of 6 centers), partly concordant (highly overlapping in ≥ 5 of 6 centers), or discordant (same in < 5 of 6 centers). Local practices were compared with strong recommendations from high-quality, evidence-based guidelines.RESULTS: The questionnaire comprised 67 questions regarding supportive care practice. Concordance was observed for 11 of 67 practice items (16%), partial concordance was observed for 6 of 67 practice items (9%), and discordance was observed for 50 of 67 practice items (75%). Adherence to strong recommendations of 4 high-quality, evidence-based guidelines varied but was generally low.CONCLUSIONS: Large variations exist in pediatric oncology supportive care practice, and this could negatively influence care. Adherence to existing evidence-based guidelines and the development and implementation of new clinical practice guidelines have the potential of standardizing supportive care practice and thereby improving outcomes for children with cancer.

AB - BACKGROUND: Current treatment strategies in pediatric oncology are intensive and lead to high survival rates but also to treatment-related complications. Therefore, supportive care plays an increasingly important role. This study was designed to evaluate variations in supportive care practice in children with cancer in the Netherlands and adherence to selected existing international guidelines through an in-depth review of local guidelines and protocols at all 6 Dutch pediatric cancer centers.METHODS: Based on shared expert opinion, a questionnaire regarding current supportive care practice was compiled. For each center, the required information was extracted from local supportive care guidelines, and the list was sent to a pediatric oncologist of that center to verify its correspondence with local daily practice. Subsequently, it was determined whether clinical practice was concordant (same in ≥ 5 of 6 centers), partly concordant (highly overlapping in ≥ 5 of 6 centers), or discordant (same in < 5 of 6 centers). Local practices were compared with strong recommendations from high-quality, evidence-based guidelines.RESULTS: The questionnaire comprised 67 questions regarding supportive care practice. Concordance was observed for 11 of 67 practice items (16%), partial concordance was observed for 6 of 67 practice items (9%), and discordance was observed for 50 of 67 practice items (75%). Adherence to strong recommendations of 4 high-quality, evidence-based guidelines varied but was generally low.CONCLUSIONS: Large variations exist in pediatric oncology supportive care practice, and this could negatively influence care. Adherence to existing evidence-based guidelines and the development and implementation of new clinical practice guidelines have the potential of standardizing supportive care practice and thereby improving outcomes for children with cancer.

KW - Antineoplastic Agents

KW - Child

KW - Drug-Related Side Effects and Adverse Reactions

KW - Evidence-Based Medicine

KW - Humans

KW - Medical Oncology

KW - Neoplasms

KW - Netherlands

KW - Pain Management

KW - Palliative Care

KW - Practice Guidelines as Topic

KW - Practice Patterns, Physicians'

KW - Radiation Injuries

KW - Radiotherapy

KW - Surveys and Questionnaires

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1002/cncr.29799

DO - 10.1002/cncr.29799

M3 - Article

VL - 122

SP - 642

EP - 650

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -

Loeffen EAH, Mulder RL, van de Wetering MD, Font-Gonzalez A, Abbink FCH, Ball LM et al. Current variations in childhood cancer supportive care in the Netherlands. Cancer. 2016 Feb 15;122(4):642-50. https://doi.org/10.1002/cncr.29799