Intervention narrows racial gaps in NSCLC treatment

  • Cykert S & al.
  • Cancer Med
  • 4 Feb 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • A multifaceted intervention program for patients with early-stage NSCLC that used race-specific data and real-time warnings of missed appointments or milestones from electronic health records monitored by a nurse navigator significantly reduced racial disparities in treatment rates.

Why this matters

  • Studies show that black patients with NSCLC undergo curative treatment less often than white patients.

Study design

  • Treatment rates of patients with early-stage NSCLC in an intervention program (n=360) were compared with retrospective (n=2841) and concurrent (n=597) control patients.
  • Funding: National Cancer Institute; American Cancer Society.

Key results

  • 31.7% of the intervention group, 15.9% of retrospective control patients, and 13.2% of concurrent control patients were black.
  • Overall treatment rate was higher in the intervention group vs the retrospective and concurrent groups, regardless of race (96% vs 76% vs 83%, respectively; P<.001 for all>
  • Overall treatment rates were higher with intervention for all patients:
    • Intervention group: 96% for both blacks and whites.
    • Retrospective group: 69% for blacks, 78% for whites.
    • Concurrent group: 79% for blacks, 84% for whites.
  • Receipt of surgery or radiation was lower for blacks in the retrospective group (aOR, 0.66; P=.001), but no racial disparity was seen in the intervention group (aOR for blacks, 2.1; P=.39).

Limitations

  • Black patients were intentionally oversampled in the intervention group.

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