Cancer care treatment attrition in adults: Measurement approaches and inequities in patient dropout rates - a rapid review.
Attrition rates
Cancer treatment adherence
Inequalities in healthcare
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
01 Nov 2024
01 Nov 2024
Historique:
received:
09
08
2024
accepted:
23
10
2024
medline:
1
11
2024
pubmed:
1
11
2024
entrez:
1
11
2024
Statut:
epublish
Résumé
Cancer treatment attrition refers to the discontinuation of prescribed cancer therapies before completion. It can significantly impact patient outcomes and cancer survival rates making it a critical concern. There is growing evidence on inequalities in cancer care, the avoidable systematic differences in the health of different groups of people. Understanding the extent of treatment attrition, why it happens, for whom, and associated inequalities may improve cancer care delivery and patient outcomes. A rapid review was conducted to identify existing evidence on measures of cancer treatment attrition, definitions, reasons for attrition and potential inequalities. The review followed a systematic approach but with abbreviated processes to facilitate quicker evidence synthesis. Searches were restricted to MEDLINE and Embase databases from their inception dates to May 7, 2024. Additional searches were performed in PubMed, Google Scholar, and key grey literature from relevant organizations. Inclusion criteria were adults with any type of cancer undergoing treatment, with studies reporting quantitative or qualitative data on treatment attrition conducted outside of clinical trials. Exclusion criteria included studies on children or adolescents, clinical trials, non-English publications, and various non-research article types. Data extraction and quality assessment were performed using standardized tools, and studies were synthesized narratively. The search retrieved 1,353 references, with 40 studies meeting inclusion criteria. Most studies were retrospective. Studies covered various cancer types and treatments, reporting measures of attrition and reasons for treatment drop-out. Factors influencing attrition included disease progression, death, clinical deterioration, treatment toxicity, and socioeconomic factors such as lower income or socioeconomic disadvantage. This review highlights significant variability in how treatment attrition is measured and defined, and suggests potential inequalities in who discontinues treatment. Standardized measures of attrition and data collection on reasons for discontinuation are essential to improve cancer care outcomes and equity. Future research should focus on developing these standardized metrics and exploring interventions targeting identified disparities to support cancer patients to complete treatment and improve outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Cancer treatment attrition refers to the discontinuation of prescribed cancer therapies before completion. It can significantly impact patient outcomes and cancer survival rates making it a critical concern. There is growing evidence on inequalities in cancer care, the avoidable systematic differences in the health of different groups of people. Understanding the extent of treatment attrition, why it happens, for whom, and associated inequalities may improve cancer care delivery and patient outcomes.
METHODS
METHODS
A rapid review was conducted to identify existing evidence on measures of cancer treatment attrition, definitions, reasons for attrition and potential inequalities. The review followed a systematic approach but with abbreviated processes to facilitate quicker evidence synthesis. Searches were restricted to MEDLINE and Embase databases from their inception dates to May 7, 2024. Additional searches were performed in PubMed, Google Scholar, and key grey literature from relevant organizations. Inclusion criteria were adults with any type of cancer undergoing treatment, with studies reporting quantitative or qualitative data on treatment attrition conducted outside of clinical trials. Exclusion criteria included studies on children or adolescents, clinical trials, non-English publications, and various non-research article types. Data extraction and quality assessment were performed using standardized tools, and studies were synthesized narratively.
RESULTS
RESULTS
The search retrieved 1,353 references, with 40 studies meeting inclusion criteria. Most studies were retrospective. Studies covered various cancer types and treatments, reporting measures of attrition and reasons for treatment drop-out. Factors influencing attrition included disease progression, death, clinical deterioration, treatment toxicity, and socioeconomic factors such as lower income or socioeconomic disadvantage.
CONCLUSIONS
CONCLUSIONS
This review highlights significant variability in how treatment attrition is measured and defined, and suggests potential inequalities in who discontinues treatment. Standardized measures of attrition and data collection on reasons for discontinuation are essential to improve cancer care outcomes and equity. Future research should focus on developing these standardized metrics and exploring interventions targeting identified disparities to support cancer patients to complete treatment and improve outcomes.
Identifiants
pubmed: 39482591
doi: 10.1186/s12885-024-13096-7
pii: 10.1186/s12885-024-13096-7
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1345Informations de copyright
© 2024. The Author(s).
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