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Published in: Journal of Neuro-Oncology 2/2024

25-04-2024 | Glioblastoma | Research

Exploring the impact of primary care utilization and health information exchange upon treatment patterns and clinical outcomes of glioblastoma patients

Authors: Megan Parker, Foad Kazemi, A. Karim Ahmed, Cathleen C. Kuo, Sumil K. Nair, Jordina Rincon-Torroella, Christopher Jackson, Gary Gallia, Chetan Bettegowda, Jon Weingart, Henry Brem, Debraj Mukherjee

Published in: Journal of Neuro-Oncology | Issue 2/2024

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Abstract

Purpose

There is limited literature describing care coordination for patients with glioblastoma (GBM). We aimed to investigate the impact of primary care and electronic health information exchange (HIE) between neurosurgeons, oncologists, and primary care providers (PCP) on GBM treatment patterns, postoperative outcomes, and survival.

Methods

We identified adult GBM patients undergoing primary resection at our institution (2007–2020). HIE was defined as shared electronic medical information between PCPs, oncologists, and neurosurgeons. Multivariate logistic regression analyses were used to determine the effect of PCPs and HIE upon initiation and completion of adjuvant therapy. Kaplan-Meier and multivariate Cox regression models were used to evaluate overall survival (OS).

Results

Among 374 patients (mean age ± SD: 57.7 ± 13.5, 39.0% female), 81.0% had a PCP and 62.4% had electronic HIE. In multivariate analyses, having a PCP was associated with initiation (OR: 7.9, P < 0.001) and completion (OR: 4.4, P < 0.001) of 6 weeks of concomitant chemoradiation, as well as initiation (OR: 4.0, P < 0.001) and completion (OR: 3.0, P = 0.007) of 6 cycles of maintenance temozolomide thereafter. Having a PCP (median OS [95%CI]: 14.6[13.1–16.1] vs. 10.8[8.2–13.3] months, P = 0.005) and HIE (15.40[12.82–17.98] vs. 13.80[12.51–15.09] months, P = 0.029) were associated with improved OS relative to counterparts in Kaplan-Meier analysis and in multivariate Cox regression analysis (hazard ratio [HR] = 0.7, [95% CI] 0.5-1.0, P = 0.048). In multivariate analyses, chemoradiation (HR = 0.34, [95% CI] 0.2–0.7, P = 0.002) and maintenance temozolomide (HR = 0.5, 95%CI 0.3–0.8, P = 0.002) were associated with improved OS relative to counterparts.

Conclusion

Effective care coordination between neurosurgeons, oncologists, and PCPs may offer a modifiable avenue to improve GBM outcomes.
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Metadata
Title
Exploring the impact of primary care utilization and health information exchange upon treatment patterns and clinical outcomes of glioblastoma patients
Authors
Megan Parker
Foad Kazemi
A. Karim Ahmed
Cathleen C. Kuo
Sumil K. Nair
Jordina Rincon-Torroella
Christopher Jackson
Gary Gallia
Chetan Bettegowda
Jon Weingart
Henry Brem
Debraj Mukherjee
Publication date
25-04-2024
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 2/2024
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-024-04677-4

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