Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis
Abstract Background Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and meta-analysis aiming to identify and synthesize existing literature on the e...
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doaj-91bc88fd42eb417bb3ef23e3112b4bbc2020-11-25T03:58:21ZengBMCSystematic Reviews2046-40532020-10-019111510.1186/s13643-020-01498-0Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysisJolanda C. van Hoeve0Robin W. M. Vernooij1Michelle Fiander2Peter Nieboer3Sabine Siesling4Thomas Rotter5Department Health Technology & Services Research, University of TwenteDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht UniversityCollege of Pharmacy, Department of Pharmacology, University of UtahWilhelmina HospitalDepartment Health Technology & Services Research, University of TwenteSchool of Nursing, Queen’s UniversityAbstract Background Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and meta-analysis aiming to identify and synthesize existing literature on the effects of pathways in oncological care. Methods All patients diagnosed with cancer in primary and secondary/tertiary care whose treatment can be characterized as the strategy “care pathways” are included in this review. A systematic search in seven databases was conducted to gather evidence. Studies were screened by two independent reviewers. Study outcomes regarding patients, professionals, and system level were extracted from each study. Results Out of 13,847 search results, we selected 158 articles eligible for full text assessment. One hundred fifty studies were excluded and the remaining eight studies represented 4786 patients. Most studies were conducted in secondary/tertiary care. Length of stay (LOS) was the most common used indicator, and was reported in five studies. Meta-analysis based on subgroups showed an overall shorter LOS regarding gastric cancer (weighted mean difference (WMD)): − 2.75, CI: − 4.67 to − 0.83) and gynecological cancer (WMD: − 1.58, CI: − 2.10 to − 1.05). Costs were reported in six studies and most studies reported lower costs for pathway groups. Conclusions Despite the differences between the included studies, we were able to present an evidence base for cancer care pathways performed in secondary/tertiary care regarding the positive effects of LOS in favor of cancer care pathways. Systematic review registration PROSPERO CRD42017057592.http://link.springer.com/article/10.1186/s13643-020-01498-0Care pathwaysClinical pathwaysIntegrated care pathwaysCare mapsOncologyCancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jolanda C. van Hoeve Robin W. M. Vernooij Michelle Fiander Peter Nieboer Sabine Siesling Thomas Rotter |
spellingShingle |
Jolanda C. van Hoeve Robin W. M. Vernooij Michelle Fiander Peter Nieboer Sabine Siesling Thomas Rotter Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis Systematic Reviews Care pathways Clinical pathways Integrated care pathways Care maps Oncology Cancer |
author_facet |
Jolanda C. van Hoeve Robin W. M. Vernooij Michelle Fiander Peter Nieboer Sabine Siesling Thomas Rotter |
author_sort |
Jolanda C. van Hoeve |
title |
Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis |
title_short |
Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis |
title_full |
Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis |
title_fullStr |
Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis |
title_full_unstemmed |
Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis |
title_sort |
effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis |
publisher |
BMC |
series |
Systematic Reviews |
issn |
2046-4053 |
publishDate |
2020-10-01 |
description |
Abstract Background Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and meta-analysis aiming to identify and synthesize existing literature on the effects of pathways in oncological care. Methods All patients diagnosed with cancer in primary and secondary/tertiary care whose treatment can be characterized as the strategy “care pathways” are included in this review. A systematic search in seven databases was conducted to gather evidence. Studies were screened by two independent reviewers. Study outcomes regarding patients, professionals, and system level were extracted from each study. Results Out of 13,847 search results, we selected 158 articles eligible for full text assessment. One hundred fifty studies were excluded and the remaining eight studies represented 4786 patients. Most studies were conducted in secondary/tertiary care. Length of stay (LOS) was the most common used indicator, and was reported in five studies. Meta-analysis based on subgroups showed an overall shorter LOS regarding gastric cancer (weighted mean difference (WMD)): − 2.75, CI: − 4.67 to − 0.83) and gynecological cancer (WMD: − 1.58, CI: − 2.10 to − 1.05). Costs were reported in six studies and most studies reported lower costs for pathway groups. Conclusions Despite the differences between the included studies, we were able to present an evidence base for cancer care pathways performed in secondary/tertiary care regarding the positive effects of LOS in favor of cancer care pathways. Systematic review registration PROSPERO CRD42017057592. |
topic |
Care pathways Clinical pathways Integrated care pathways Care maps Oncology Cancer |
url |
http://link.springer.com/article/10.1186/s13643-020-01498-0 |
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