title: Rates of guideline adherence among US community oncologists treating NSCLC.
abstract: OBJECTIVE
  To evaluate chemotherapy regimen utilization in patients with non-small cell lung cancer (NSCLC) treated in US community oncology practices, to examine the relationship between evidence-based guideline adherence and the follow-up monitoring period (FUMP) over 1.5 years, and to understand the relative costs of commonly administered chemotherapy regimens.
  
  
  METHODS
  Retrospective data analysis.
  
  
  METHODS
  Using a large US medical oncology clinical database derived from a proprietary web-based drug dispensing technology, we identified adult patients with NSCLC who started adjuvant therapy for early-stage disease or first-line therapy for advanced and metastatic disease from July 1, 2009, through June 30, 2010. Adjuvant or first-line regimen utilization and the FUMP within 1.5 years were analyzed with respect to national evidence-based guideline adherence. Costs for commonly administered regimens based on 2010 Medicare reimbursement were compared.
  
  
  RESULTS
  A total of 3505 patient treatment regimens were included in this study. Rates of guideline adherence were 75.0% and 61.3% for the first-line and the adjuvant treatment groups, respectively (P < .0001). Treatment with guidelinebased regimens correlated with a significantly longer FUMP in the first-line treatment groupcompared with non-guideline-based regimens (P = .005). Regimen costs for the top 11 regimens in the adjuvant and first-line treatment settings varied greatly. Low-cost regimens were prescribed more commonly.
  
  
  CONCLUSIONS
  Rates of guideline adherence were significantly higher in the first-line than in the adjuvant NSCLC treatment group. First-line treatment with guideline-based regimens correlated with an extended FUMP for advanced NSCLC patients.
authors.affiliation: McKesson Specialty Health, McKesson, 123 Mission St, San Francisco, CA 94105, USA. zhaohui.wang@mckesson.com
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Wang
authors.forename: Inga
authors.initials: I
authors.lastname: Askamit
authors.forename: Lisa
authors.initials: L
authors.lastname: Tuscher
authors.forename: Kim
authors.initials: K
authors.lastname: Bergstrom
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008495:Medical Oncology / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D017239:Paclitaxel / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin