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Exploring the impact of primary care utilization and health information exchange upon treatment patterns and clinical outcomes of glioblastoma patients.

Authors :
Parker, Megan
Kazemi, Foad
Ahmed, A. Karim
Kuo, Cathleen C.
Nair, Sumil K.
Rincon-Torroella, Jordina
Jackson, Christopher
Gallia, Gary
Bettegowda, Chetan
Weingart, Jon
Brem, Henry
Mukherjee, Debraj
Source :
Journal of Neuro-Oncology; Jun2024, Vol. 168 Issue 2, p345-353, 9p
Publication Year :
2024

Abstract

Purpose: There is limited literature describing care coordination for patients with glioblastoma (GBM). We aimed to investigate the impact of primary care and electronic health information exchange (HIE) between neurosurgeons, oncologists, and primary care providers (PCP) on GBM treatment patterns, postoperative outcomes, and survival. Methods: We identified adult GBM patients undergoing primary resection at our institution (2007–2020). HIE was defined as shared electronic medical information between PCPs, oncologists, and neurosurgeons. Multivariate logistic regression analyses were used to determine the effect of PCPs and HIE upon initiation and completion of adjuvant therapy. Kaplan-Meier and multivariate Cox regression models were used to evaluate overall survival (OS). Results: Among 374 patients (mean age ± SD: 57.7 ± 13.5, 39.0% female), 81.0% had a PCP and 62.4% had electronic HIE. In multivariate analyses, having a PCP was associated with initiation (OR: 7.9, P < 0.001) and completion (OR: 4.4, P < 0.001) of 6 weeks of concomitant chemoradiation, as well as initiation (OR: 4.0, P < 0.001) and completion (OR: 3.0, P = 0.007) of 6 cycles of maintenance temozolomide thereafter. Having a PCP (median OS [95%CI]: 14.6[13.1–16.1] vs. 10.8[8.2–13.3] months, P = 0.005) and HIE (15.40[12.82–17.98] vs. 13.80[12.51–15.09] months, P = 0.029) were associated with improved OS relative to counterparts in Kaplan-Meier analysis and in multivariate Cox regression analysis (hazard ratio [HR] = 0.7, [95% CI] 0.5-1.0, P = 0.048). In multivariate analyses, chemoradiation (HR = 0.34, [95% CI] 0.2–0.7, P = 0.002) and maintenance temozolomide (HR = 0.5, 95%CI 0.3–0.8, P = 0.002) were associated with improved OS relative to counterparts. Conclusion: Effective care coordination between neurosurgeons, oncologists, and PCPs may offer a modifiable avenue to improve GBM outcomes. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
0167594X
Volume :
168
Issue :
2
Database :
Complementary Index
Journal :
Journal of Neuro-Oncology
Publication Type :
Academic Journal
Accession number :
177623804
Full Text :
https://doi.org/10.1007/s11060-024-04677-4