Further work is needed to implement and validate this tool. The proposed tool provides a framework for specialty pharmacies to deliver quality care in the use of tyrosine kinase inhibitors for the treatment of non-small cell lung cancer. Most stakeholders agreed that the proposed measures were relevant as well as accurate and expressed support for implementation. The finalized guide assesses safety, efficacy, persistence, and patient-reported outcomes using defined clinical and specialty pharmacy measures. Quality measures for the utilization of tyrosine kinase inhibitors in non-small cell lung cancer were developed by conducting package insert, guideline, and literature review followed by integrating feedback from key stakeholder groups through individual conversations and a structured assessment. The purpose of this initiative was to develop a tool to assess quality in the utilization of tyrosine kinase inhibitors in non-small cell lung cancer by engaging multiple key stakeholder perspectives to identify the fundamental elements of high-quality clinical and specialty pharmacy care. With integrated clinical and pharmaceutical care services, a health-system specialty pharmacy is the ideal setting for quality measures development. Quality measures to ensure appropriate utilization and monitoring of tyrosine kinase inhibitors are needed to reduce unnecessary healthcare costs and maximize therapeutic benefit. Tyrosine kinase inhibitors, commonly prescribed for non-small cell lung cancer, are efficacious but pose safety risks that can diminish quality of life. There is no correlation in Caucasian population.
The sensitivity to platinum chemotherapy in patients with ERCC1 protein negative expression in the middle and late stages of NSCLC is better than that in patients with positive expression, especially in Asian population.
The results of ethnicity subgroup analysis showed that there was no significant difference, with OR of 0.50 (95% CI: 0.31∼0.82 P=0.001) in Asian population and OR of 0.56 (95% CI: 0.30∼1.07) in Caucasian population. Stata 15.0 was used for statistical analysis, and ethnicity subgroup analysis was taken.įinally, 14 studies were included and 1337 patients were involved, of which 697 were ERCC1 positive, with a positive rate of 53.5%. The literature on the expression of ERCC1 and platinum chemosensitivity in patients with advanced NSCLC was searched in computer, which was published from January 2009 to August 2019 on the databases such as China Journal Full-text Database (CJFD), China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP, PubMed, EMBASE, and others. To carry out the meta-analysis on the relationship between the expression of nucleotide excision repair cross-complementary enzyme 1 (ERCC1) protein and platinum chemosensitivity in patients with advanced non-small-cell lung cancer (NSCLC). Guided by the new indicator structure, a set of indicators suitable for Chinese healthcare system was developed and can be utilized to measure and improve the care quality of non-small cell lung cancer. Therefore, 21 indicators got the final consensus of the Expert Panel.
#China astroboard plus#
Seventy four indicators were extracted from guidelines and relevant literatures as potential indicators 43 indicators plus 1 suggested indicator were remained after the discussion of Round 1 questionnaires of Round 2 were rated by Expert Panel and 19 indicators met the inclusion criteria and entered Round 3 2 of the eliminated indicators in Round 2 were retrieved by the Expert Panel at the in-person meeting (Round 3). Under the new framework, potential indicators were collected and a 3-round modified Delphi process was conducted by a national multi-disciplinary Expert Panel to develop a set of indicators until they reached the final consensus.Ī new indicator framework (structure, process, communication, management of symptoms or treatment toxicity and outcome) was developed. We constructed a new indicator framework based on the characteristics of NSCLC care and the nature of Chinese health care system. The goal of the study is to set up a group of Chinese quality indicators for NSCLC care and make it the first step towards the improvement of NSCLC care quality in China. Yet there is no such an indicators system specifically suitable for Chinese health care system.
Results of some studies have shown that assessment of care quality can help to make improvement and the development of quality indicators is deemed as the initial and most essential part. Large gap exists between clinical practice and recommended care and large room exists for the improvement of care quality for non-small cell lung cancer (NSCLC) in China.