Significant Improvement In Performance On Metrics For Quality Oncology Care

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Significant Improvement In Performance On Metrics For Quality Oncology Care

Main Category: Cancer / Oncology

Article Date: 13 Mar 2013

Summary of a study published online in the Journal of Clinical Oncology, analyzing self-reported data from 156 outpatient oncology practices participating in the American Society of Clinical Oncology's Quality Oncology Practice Initiative (QOPI®) showing significant improvements in performance on certain measures for quality oncology cancer care over a four-year period.

Overall, mean normalized performance scores from participating practices rose from 71 to 85 percent between 2006 and 2010; improvements were especially profound on measures related to adoption of new clinical practice standards. Quote for attribution to Sandra M. Swain, MD, FACP, ASCO President.

An analysis of self-reported data from outpatient oncology practices that participated in the American Society of Clinical Oncology's Quality Oncology Practice Initiative (QOPI®) found a significant increase in performance on quality measures for oncology care over a four-year period, especially in adopting new clinical practices. The study was published in the Journal of Clinical Oncology.

QOPI is a voluntary, national quality self-assessment and improvement program that allows outpatient oncology practices to compare the care they provide against guideline recommendations. Participation in QOPI has been growing steadily since the program's inception in 2006; more than 800 practices have registered to date.

Researchers analyzed data from 156 oncology practices, finding that the mean normalized performance score improved from 71 to 85 percent between 2006 and 2010. A further review of the data found the following trends:

Practices perform well on numerous quality measures: For example, participating practices reported consistently high rates (90 percent or higher) of providing postoperative (adjuvant) chemotherapy for breast, colorectal and non-small cell lung cancers, as recommended. Adjuvant therapy is proven to extend survival - and often offer cures - for many patients with these cancers.
Improved uptake of new clinical practices: Mean scores of measures related to new clinical practices (based on new guidelines or clinical evidence) improved from 5 to 69 percent overall over four years. These new clinical practices include genetic testing for tumor molecular markers that predict response to treatment in patients with metastatic colorectal cancer (KRAS gene alterations before administering anti-EGFR therapy), adequate lymph node examination after surgery in colorectal cancer, testing for, and use of the anti-nausea drug aprepitant when certain chemotherapy regimens are administered.
There are opportunities for improvement for certain measures: Measures that assess smoking cessation and fertility preservation counseling (for patients undergoing treatment that could render them infertile) did not improve over time. Performance on these measures ranged from a high of 34 percent for smoking cessation counseling to a low of 6 percent for discussion of fertility preservation.

"These findings demonstrate that oncologists are consistently performing at high levels in many core areas of care and are quickly incorporating new standard tests and treatments into everyday practice," said lead author Michael N. Neuss, MD, chief medical officer at the Vanderbilt-Ingram Cancer Center and Chair of the QOPI Steering Group. "These data also show that participation in quality measurement programs, like QOPI, is correlated with substantial improvement in adherence to clinical practice standards."

QOPI holds its two semi-annual collection rounds in the spring and fall. The current analysis included 156 practices that participated in at least two collection rounds and reported data from 30 or more patient charts per round. Performance scores (rates of adherence to quality measures) were calculated for seven categories of quality measures (also known as QOPI modules; includes: core measures, symptom/toxicity management, care at end of life, non-Hodgkin's lymphoma, breast cancer, colorectal cancer, and non-small cell lung cancer), which collectively include more than 150 measures.

ASCO Perspective
Sandra M. Swain, MD, FACP, ASCO President

"This study further shows that participation in quality assessment programs like QOPI should provide reassurance to people living with cancer that they are receiving high quality care. Nearly 600 practices in the U.S. are already participating in QOPI in part because it provides a systematic process, library of diverse quality measures, collection tool, and reliable information to assess the care they provide. QOPI is also the gateway to QOPI-Certification which recognizes practices that demonstrate performance on designated QOPI measures and meet certification standards for quality and safe care."

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