Impact of multidisciplinary care on processes of cancer care

A multi-institutional study

Eberechukwu Onukwugha, Nicholas J. Petrelli, Kathleen M. Castro, James F. Gardner, Jinani Jayasekera, Olga Goloubeva, Ming T. Tan, Erica J. McNamara, Howard A. Zaren, Thomas Asfeldt, James D. Bearden, Andrew L. Salner, Mark J. Krasna, Irene Prabhu Das, Steve B. Clauser, Eberechukwu Onukwugha, Nicholas J. Petrelli, Kathleen M. Castro, James F. Gardner, Jinani Jayasekera & 10 others Olga Goloubeva, Ming T. Tan, Erica J. McNamara, Howard A. Zaren, Thomas Asfeldt, James D. Bearden, Andrew L. Salner, Mark J. Krasna, Irene Prabhu Das, Steve B. Clauser

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose The role of multidisciplinary care (MDC) on cancer care processes is not fully understood. We investigated the impact of MDC on the processes of care at cancer centers within the National Cancer Institute Community Cancer Centers Program (NCCCP). Methods The study used data from patients diagnosed with stage IIB to III rectal cancer, stage III colon cancer, and stage III non-small-cell lung cancer at 14 NCCCP cancer centers from 2007 to 2012. We used an MDC development assessment tool-with levels ranging from evolving MDC (low) to achieving excellence (high)-to measure the level of MDC implementation in seven MDC areas, such as case planning and physician engagement. Descriptive statistics and cluster-adjusted regression models quantified the association between MDC implementation and processes of care, including time from diagnosis to treatment receipt. Results A total of 1,079 patients were examined. Compared with patients with colon cancer treated at cancer centers reporting lowMDCscores, time to treatment receiptwas shorter for patients with colon cancer treated at cancer centers reporting high or moderate MDC scores for physician engagement (hazard ratio [HR] for high physician engagement, 2.66; 95% CI, 1.70 to 4.17; HR for moderate physician engagement, 1.50; 95% CI, 1.19 to 1.89) and longer for patients with colon cancer treated at cancer centers reporting high 2MDC scores for case planning (HR, 0.65; 95% CI, 0.49 to 0.85). Results for patients with rectal cancer were qualitatively similar, and there was no statistically significant difference among patients with lung cancer. Conclusion MDC implementation level was associated with processes of care, and direction of association varied across MDC assessment areas.

Original languageEnglish (US)
Pages (from-to)e157-e168
JournalJournal of oncology practice
Volume12
Issue number2
DOIs
StatePublished - Feb 1 2016

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Colonic Neoplasms
Neoplasms
Physicians
Rectal Neoplasms
National Cancer Institute (U.S.)
Non-Small Cell Lung Carcinoma
Lung Neoplasms
Therapeutics
carbonyl cyanide-4-nitro-2-chlorophenylhydrazone

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Onukwugha, E., Petrelli, N. J., Castro, K. M., Gardner, J. F., Jayasekera, J., Goloubeva, O., ... Clauser, S. B. (2016). Impact of multidisciplinary care on processes of cancer care: A multi-institutional study. Journal of oncology practice, 12(2), e157-e168. https://doi.org/10.1200/JOP.2015.004200

Impact of multidisciplinary care on processes of cancer care : A multi-institutional study. / Onukwugha, Eberechukwu; Petrelli, Nicholas J.; Castro, Kathleen M.; Gardner, James F.; Jayasekera, Jinani; Goloubeva, Olga; Tan, Ming T.; McNamara, Erica J.; Zaren, Howard A.; Asfeldt, Thomas; Bearden, James D.; Salner, Andrew L.; Krasna, Mark J.; Das, Irene Prabhu; Clauser, Steve B.; Onukwugha, Eberechukwu; Petrelli, Nicholas J.; Castro, Kathleen M.; Gardner, James F.; Jayasekera, Jinani; Goloubeva, Olga; Tan, Ming T.; McNamara, Erica J.; Zaren, Howard A.; Asfeldt, Thomas; Bearden, James D.; Salner, Andrew L.; Krasna, Mark J.; Prabhu Das, Irene; Clauser, Steve B.

In: Journal of oncology practice, Vol. 12, No. 2, 01.02.2016, p. e157-e168.

Research output: Contribution to journalArticle

Onukwugha, E, Petrelli, NJ, Castro, KM, Gardner, JF, Jayasekera, J, Goloubeva, O, Tan, MT, McNamara, EJ, Zaren, HA, Asfeldt, T, Bearden, JD, Salner, AL, Krasna, MJ, Das, IP, Clauser, SB, Onukwugha, E, Petrelli, NJ, Castro, KM, Gardner, JF, Jayasekera, J, Goloubeva, O, Tan, MT, McNamara, EJ, Zaren, HA, Asfeldt, T, Bearden, JD, Salner, AL, Krasna, MJ, Prabhu Das, I & Clauser, SB 2016, 'Impact of multidisciplinary care on processes of cancer care: A multi-institutional study', Journal of oncology practice, vol. 12, no. 2, pp. e157-e168. https://doi.org/10.1200/JOP.2015.004200
Onukwugha E, Petrelli NJ, Castro KM, Gardner JF, Jayasekera J, Goloubeva O et al. Impact of multidisciplinary care on processes of cancer care: A multi-institutional study. Journal of oncology practice. 2016 Feb 1;12(2):e157-e168. https://doi.org/10.1200/JOP.2015.004200
Onukwugha, Eberechukwu ; Petrelli, Nicholas J. ; Castro, Kathleen M. ; Gardner, James F. ; Jayasekera, Jinani ; Goloubeva, Olga ; Tan, Ming T. ; McNamara, Erica J. ; Zaren, Howard A. ; Asfeldt, Thomas ; Bearden, James D. ; Salner, Andrew L. ; Krasna, Mark J. ; Das, Irene Prabhu ; Clauser, Steve B. ; Onukwugha, Eberechukwu ; Petrelli, Nicholas J. ; Castro, Kathleen M. ; Gardner, James F. ; Jayasekera, Jinani ; Goloubeva, Olga ; Tan, Ming T. ; McNamara, Erica J. ; Zaren, Howard A. ; Asfeldt, Thomas ; Bearden, James D. ; Salner, Andrew L. ; Krasna, Mark J. ; Prabhu Das, Irene ; Clauser, Steve B. / Impact of multidisciplinary care on processes of cancer care : A multi-institutional study. In: Journal of oncology practice. 2016 ; Vol. 12, No. 2. pp. e157-e168.
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abstract = "Purpose The role of multidisciplinary care (MDC) on cancer care processes is not fully understood. We investigated the impact of MDC on the processes of care at cancer centers within the National Cancer Institute Community Cancer Centers Program (NCCCP). Methods The study used data from patients diagnosed with stage IIB to III rectal cancer, stage III colon cancer, and stage III non-small-cell lung cancer at 14 NCCCP cancer centers from 2007 to 2012. We used an MDC development assessment tool-with levels ranging from evolving MDC (low) to achieving excellence (high)-to measure the level of MDC implementation in seven MDC areas, such as case planning and physician engagement. Descriptive statistics and cluster-adjusted regression models quantified the association between MDC implementation and processes of care, including time from diagnosis to treatment receipt. Results A total of 1,079 patients were examined. Compared with patients with colon cancer treated at cancer centers reporting lowMDCscores, time to treatment receiptwas shorter for patients with colon cancer treated at cancer centers reporting high or moderate MDC scores for physician engagement (hazard ratio [HR] for high physician engagement, 2.66; 95{\%} CI, 1.70 to 4.17; HR for moderate physician engagement, 1.50; 95{\%} CI, 1.19 to 1.89) and longer for patients with colon cancer treated at cancer centers reporting high 2MDC scores for case planning (HR, 0.65; 95{\%} CI, 0.49 to 0.85). Results for patients with rectal cancer were qualitatively similar, and there was no statistically significant difference among patients with lung cancer. Conclusion MDC implementation level was associated with processes of care, and direction of association varied across MDC assessment areas.",
author = "Eberechukwu Onukwugha and Petrelli, {Nicholas J.} and Castro, {Kathleen M.} and Gardner, {James F.} and Jinani Jayasekera and Olga Goloubeva and Tan, {Ming T.} and McNamara, {Erica J.} and Zaren, {Howard A.} and Thomas Asfeldt and Bearden, {James D.} and Salner, {Andrew L.} and Krasna, {Mark J.} and Das, {Irene Prabhu} and Clauser, {Steve B.} and Eberechukwu Onukwugha and Petrelli, {Nicholas J.} and Castro, {Kathleen M.} and Gardner, {James F.} and Jinani Jayasekera and Olga Goloubeva and Tan, {Ming T.} and McNamara, {Erica J.} and Zaren, {Howard A.} and Thomas Asfeldt and Bearden, {James D.} and Salner, {Andrew L.} and Krasna, {Mark J.} and {Prabhu Das}, Irene and Clauser, {Steve B.}",
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T1 - Impact of multidisciplinary care on processes of cancer care

T2 - A multi-institutional study

AU - Onukwugha, Eberechukwu

AU - Petrelli, Nicholas J.

AU - Castro, Kathleen M.

AU - Gardner, James F.

AU - Jayasekera, Jinani

AU - Goloubeva, Olga

AU - Tan, Ming T.

AU - McNamara, Erica J.

AU - Zaren, Howard A.

AU - Asfeldt, Thomas

AU - Bearden, James D.

AU - Salner, Andrew L.

AU - Krasna, Mark J.

AU - Das, Irene Prabhu

AU - Clauser, Steve B.

AU - Onukwugha, Eberechukwu

AU - Petrelli, Nicholas J.

AU - Castro, Kathleen M.

AU - Gardner, James F.

AU - Jayasekera, Jinani

AU - Goloubeva, Olga

AU - Tan, Ming T.

AU - McNamara, Erica J.

AU - Zaren, Howard A.

AU - Asfeldt, Thomas

AU - Bearden, James D.

AU - Salner, Andrew L.

AU - Krasna, Mark J.

AU - Prabhu Das, Irene

AU - Clauser, Steve B.

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N2 - Purpose The role of multidisciplinary care (MDC) on cancer care processes is not fully understood. We investigated the impact of MDC on the processes of care at cancer centers within the National Cancer Institute Community Cancer Centers Program (NCCCP). Methods The study used data from patients diagnosed with stage IIB to III rectal cancer, stage III colon cancer, and stage III non-small-cell lung cancer at 14 NCCCP cancer centers from 2007 to 2012. We used an MDC development assessment tool-with levels ranging from evolving MDC (low) to achieving excellence (high)-to measure the level of MDC implementation in seven MDC areas, such as case planning and physician engagement. Descriptive statistics and cluster-adjusted regression models quantified the association between MDC implementation and processes of care, including time from diagnosis to treatment receipt. Results A total of 1,079 patients were examined. Compared with patients with colon cancer treated at cancer centers reporting lowMDCscores, time to treatment receiptwas shorter for patients with colon cancer treated at cancer centers reporting high or moderate MDC scores for physician engagement (hazard ratio [HR] for high physician engagement, 2.66; 95% CI, 1.70 to 4.17; HR for moderate physician engagement, 1.50; 95% CI, 1.19 to 1.89) and longer for patients with colon cancer treated at cancer centers reporting high 2MDC scores for case planning (HR, 0.65; 95% CI, 0.49 to 0.85). Results for patients with rectal cancer were qualitatively similar, and there was no statistically significant difference among patients with lung cancer. Conclusion MDC implementation level was associated with processes of care, and direction of association varied across MDC assessment areas.

AB - Purpose The role of multidisciplinary care (MDC) on cancer care processes is not fully understood. We investigated the impact of MDC on the processes of care at cancer centers within the National Cancer Institute Community Cancer Centers Program (NCCCP). Methods The study used data from patients diagnosed with stage IIB to III rectal cancer, stage III colon cancer, and stage III non-small-cell lung cancer at 14 NCCCP cancer centers from 2007 to 2012. We used an MDC development assessment tool-with levels ranging from evolving MDC (low) to achieving excellence (high)-to measure the level of MDC implementation in seven MDC areas, such as case planning and physician engagement. Descriptive statistics and cluster-adjusted regression models quantified the association between MDC implementation and processes of care, including time from diagnosis to treatment receipt. Results A total of 1,079 patients were examined. Compared with patients with colon cancer treated at cancer centers reporting lowMDCscores, time to treatment receiptwas shorter for patients with colon cancer treated at cancer centers reporting high or moderate MDC scores for physician engagement (hazard ratio [HR] for high physician engagement, 2.66; 95% CI, 1.70 to 4.17; HR for moderate physician engagement, 1.50; 95% CI, 1.19 to 1.89) and longer for patients with colon cancer treated at cancer centers reporting high 2MDC scores for case planning (HR, 0.65; 95% CI, 0.49 to 0.85). Results for patients with rectal cancer were qualitatively similar, and there was no statistically significant difference among patients with lung cancer. Conclusion MDC implementation level was associated with processes of care, and direction of association varied across MDC assessment areas.

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