title: National compliance to an evidence-based multidisciplinary guideline on pancreatic and periampullary carcinoma.
abstract: BACKGROUND
  We evaluated national compliance to selected quality indicators from the Dutch multidisciplinary evidence-based guideline on pancreatic and periampullary carcinoma and identified areas for improvement.
  
  
  METHODS
  Compliance to 3 selected quality indicators from the guideline was evaluated before and after implementation of the guideline in 2011: 1) adjuvant chemotherapy after tumor resection for pancreatic carcinoma, 2) discussion of the patient within a multidisciplinary team (MDT) meeting and 3) a maximum 3-week interval between final MDT meeting and start of treatment.
  
  
  RESULTS
  In total 5086 patients with pancreatic or periampullary carcinoma were included. In 2010, 2522 patients were included and in 2012, 2564 patients. 1) Use of adjuvant chemotherapy following resection for pancreatic carcinoma increased significantly from 45% (120 out of 268) in 2010 to 54% (182 out of 336) in 2012 which was mainly caused by an increase in patients aged <75 years. 2) In 2012, 64% (896 of 1396) of patients suspected of a pancreatic or periampullary carcinoma was discussed within a MDT meeting which was higher in patients aged <75 years and patients starting treatment with curative intent. 3) In 2012, the recommended 3 weeks between final MDT meeting and start of treatment was met in 39% (141 of 363) of patients which was not influenced by patient and tumor characteristics.
  
  
  CONCLUSIONS
  Compliance to three selected quality indicators in pancreatic cancer care was low in 2012. Areas for improvement were identified. Future compliance will be investigated through structured audit and feedback from the Dutch Pancreatic Cancer Audit.
authors.affiliation: Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Lennart B
authors.initials: LB
authors.lastname: van Rijssen
authors.affiliation: Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
authors.forename: Lydia G M
authors.initials: LG
authors.lastname: van der Geest
authors.affiliation: Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Radiology, St. Antonius Hospital, Nieuwegein/Utrecht, The Netherlands.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Bollen
authors.affiliation: Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Gastroenterology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Marco J
authors.initials: MJ
authors.lastname: Bruno
authors.affiliation: Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Ate
authors.initials: A
authors.lastname: van der Gaast
authors.affiliation: Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Veerbeek
authors.affiliation: Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Fibo J W
authors.initials: FJ
authors.lastname: Ten Kate
authors.affiliation: Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: o.r.busch@amc.nl.
authors.forename: Olivier R C
authors.initials: OR
authors.lastname: Busch
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000453:epidemiology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Adherence; Carcinoma; Compliance; Guideline; Pancreas; Periampullary