Having multidisciplinary teams of doctors working together improves care for patients with brain metastases. New "consensus indicators" will help hospitals ensure patients are getting the best care possible.
An international panel of top cancer doctors led by UVA Health experts has identified indicators that reflect the effectiveness of coordinated team care to improve outcomes for patients with brain metastases – cancers that have spread to the brain.
“Metastases are the most frequent type of brain cancer, but the care of patients is often inconsistent and uncoordinated,” said Camilo E. Fadul, MD, a neuro-oncologist (a neurologist with brain cancer specialization) at UVA Health. “We propose a set of indicators that can improve treatment decisions. This will identify quality improvement strategies and generate benchmarks for resource utilization.”
“Until now, there hasn’t been agreement on how the quality of care of patients with brain metastases should be measured. This new tool allows researchers and providers to recognize how to improve the quality of care and outcomes,” said co-author Roger Anderson, PhD, a population health scientist and associate director of UVA Cancer Center.
‘Urgent Need’ in Brain Metastases Care
Fadul, Anderson and UVA colleagues Jason P. Sheehan and Gloribel Bonilla
are among the authors of an article in the scientific journal Lancet Oncology that details the consensus findings of an international panel of experts in five fields – medical oncology, neuro-oncology, neurosurgery, radiation oncology and palliative care. The experts reviewed 48 potential indicators of high-quality metastasis care before settling on 29 measurements agreed to be of critical importance.
The indicators include metrics such as time from diagnosis to the start of treatment, and documentation that doctors discuss with patients about the potential benefits and side effects of different treatment approaches, all to ensure the patients are actively engaged in their care.
Other indicators include screening patients for quality-of-life concerns such as anxiety, depression and pain; documenting discussions of patients’ prognoses in their medical records; and having care recommendations come from an interdisciplinary team or tumor board.
“This set of indicators from the physicians’ perspective is the first in a multistep process that the UVA Brain Metastases Program has embarked on,” Fadul said. “We have an ongoing study involving other academic medical centers to assess the values and needs of patients and caregivers when making treatment decisions. Our goal is to prolong and preserve the quality of life of patients with brain metastases by transforming the delivery of care.”
UVA Cancer Center has the only multidisciplinary Brain Metastases Program in Virginia.
The National Cancer Institute has recognized UVA Cancer Center’s efforts to improve cancer care and pioneer new and better ways to treat cancer by designating UVA as one of only 57 “comprehensive” cancer centers in the country. The designation honors elite cancer centers with the most outstanding cancer programs in the United States.
Indicators Published
The Lancet Oncology article was written by Fadul, Sheehan, Julio Silvestre, Bonilla, Joseph Bovi, Manmeet Ahluwalia, Riccardo Soffietti, David Hui and Anderson. A list of the authors’ disclosures is included in the paper.
UVA Cancer Center supported the study.
To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog.
