Prostate cancer treatment inconsistent with guidelines

Clinical care for men with advanced prostate cancer is in major need of improvement, prompting the rollout of a collaborative research project in NSW, led by the Sax Institute.

The most recently available data indicate only 10% of NSW men with high-risk prostate cancer following surgery receive care that meets recommended guidelines, a research fellow with the Institute, Bea Brown, said.

“Clinical practice guidelines have been developed to ensure clinical decision-making is informed by recent, credible research evidence,” Ms Brown said.

“But timely and effective implementation of these guidelines into practice is inconsistent.”

Harnessing clinical networks

Speaking at the University of Sydney for the School of Public Health research presentation day, Ms Brown said her work with the Sax Institute’s Implementation Research Group aims to improve this by using a clinical network of urology experts to distribute research evidence into practice.

“The goal of our research is to reduce the evidence-practice gap by testing strategies to translate knowledge from evidence, such as clinical trials, into practice across the healthcare system,” she said.

A coordinated program of 30 clinical networks, institutes and taskforces has been established by the NSW Agency for Clinical Innovation (ACI). These networks provide a framework for clinicians and consumers to work together to improve service delivery and care outcomes for particular conditions.

Ms Brown’s research team will harness the urology clinical network to reduce variation and increase adherence to the clinical practice guidelines for men with high-risk prostate cancer.

Moving from evidence to clinical practice

Through a series of workshops, interviews and questionnaires conducted with clinicians and patients, the researchers have identified potential barriers to implementing the guidelines into practice.

To overcome these barriers, the researchers will distribute a tailored mix of written materials and presentations from opinion leaders summarising the latest evidence. They will also implement automated reminders and the collection of ongoing hospital feedback in the clinical setting. They will then monitor the results to see what works best.

As well as improving care for men with advanced prostate cancer, the findings will help the ACI determine if its clinical networks are effective change agents and demonstrate how they can best be used to improve patient care across the NSW health system.

The project is in collaboration with the NSW Agency for Clinical Innovation, the Prostate Cancer Foundation of Australia, Cancer Council NSW and the University of Sydney.

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