Physicians’ attitudes and perceived barriers to adherence to the national breast cancer clinical practice guidelines in Mexico: a survey study

• Bertha Alejandra Martinez-Cannon ^[5] ; Enrique Soto-Perez-de-Celis ^[1] ; Aura Erazo Valle-Solis ^[2] ; Claudia Arce-Salinas ^[6] ; Enrique Bargallo-Rocha ^[6] ; Veronica Bautista-Piña ^[7] ; Guadalupe Cervantes-Sanchez ^[2] ; Christian Haydeé Flores-Balcázar ^[8] ; Maria del Carmen Lara Tamburrino ^[9] ; Ana Lluch ^[3] ; Antonio Maffuz-Aziz ^[10] ; Victor Manuel Pérez-Sánchez ^[11] ; Adela Poitevin-Chacón ^[12] ; Efraín Salas-González ^[13] ; Laura Torrecillas Torres ^[2] ; Vicente Valero ^[4] ; Yolanda Villaseñor-Navarro ^[14] ; Jesús Cárdenas-Sánchez ^[15]
  1. [1] Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

     Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

     México

     
  2. [2] Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

     Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

     México

     
  3. [3] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  4. [4] University of Texas MD Anderson Cancer Center

     University of Texas MD Anderson Cancer Center

     Estados Unidos

     
  5. [5] Servicio de de Hematología-Oncología, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
  6. [6] Departamento de Tumores Mamarios, Instituto Nacional de Cancerología, Ciudad de México, México
  7. [7] Instituto de Enfermedades de la Mama FUCAM, Ciudad de México, México
  8. [8] Servicio de Radioterapia y Física Médica, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
  9. [9] Imagenología Mamaria, CT Scanner del Sur, Ciudad de México, México
  10. [10] Servicio de Oncología Quirúrgica, American British Cowdray Medical Center, Ciudad de México, México
  11. [11] Servicio de Patología Quirúrgica, Instituto Nacional de Cancerologia, Ciudad de México, México
  12. [12] Servicio de Oncología Radioterápica, Medica SUR, Ciudad de México, México
  13. [13] Hospital de Gineco-Obstetricia, Centro Médico Nacional de Occidente IMSS, Guadalajara, México
  14. [14] Subdireccion de Servicios Auxiliares de Diagnostico Y Tratamiento, Instituto Nacional de Cancerologia, Ciudad de México, México
  15. [15] Instituto Estatal de Cancerologia, Colima, México

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 1 (January), 2023, págs. 151-159
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background Adherence to clinical practice guidelines improves outcomes for patients with breast cancer. However, their implementation may not be feasible in low- and middle-income countries. This study aimed to evaluate physicians’ adherence, attitudes, and barriers towards the Colima Consensus, which is the Mexican national breast cancer clinical practice guideline.

    Methods A cross-sectional, 31-item survey was e-mailed to Consensus attendees and members of the Mexican Society of Oncology and Mexican Mastology Association. Descriptive statistics, univariate, and multivariate analysis were used to analyze the associations between participants’ characteristics, adherence, attitudes, and barriers.

    Results Of 439 respondents, 78% percent adhered to Consensus recommendations and 94% believed it was applicable to their clinical practice. Forty percent reported using the Consensus as their sole breast cancer guideline. This was associated with being a surgical oncologist (OR 3.3, 95% CI 2.0–5.3) and practicing at a public hospital (OR 2.1, 95% CI 1.2–3.7). The most common barriers to adherence were lack of resources and logistical problems. Regarding attitudes towards the Consensus, 90% considered it a good educational tool, 89% considered it a reliable source of information, and 90% thought it improved quality of care.

    Conclusions We showed high levels of adherence and positive attitudes towards the Colima Consensus, with a significant proportion of physicians using it as their only guideline. Lack of resources and logistical issues were the main barriers to adherence. Our results highlight the relevance of local breast cancer guidelines and suggest a need for the creation of resource-stratified guidelines.