De-Implementing Ineffective and Low-value Clinical Practices: Research and Practice Opportunities in Community Oncology Settings
Cet article décrit les principaux obstacles affectant la mise en place de stratégies permettant de réduire ou d'arrêter les pratiques cliniques inefficaces en cancérologie
Patients, practitioners, and policymakers are increasingly concerned about the delivery of ineffective or low-value clinical practices in cancer care settings. Research is needed on how to effectively de-implement these types of practices from cancer care. In this commentary, we spotlight the National Cancer Institute (NCI) Community Oncology Research Program (NCORP), a national network of community oncology practices, and elaborate on how it is an ideal infrastructure for conducting rigorous, real-world research on de-implementation. We describe key, multi-level issues that affect de-implementation and also serve as a guidepost for developing strategies to drive de-implementation. We describe optimal study designs for testing de-implementation strategies and elaborate on how and why the NCORP network is uniquely positioned to conduct rigorous and impactful de-implementation trials. The number and diversity of affiliated community oncology care sites, coupled with the overall objective of improving cancer care delivery, make the NCORP an opportune infrastructure for advancing de-implementation research while simultaneously improving the care of millions of cancer patients nationwide.
JNCI Cancer Spectrum , article en libre accès, 2020